Chemotherapy - previously treated LC

[AMay]

Hello All,

I’m looking to speak to anyone who has had/is having chemotherapy for stage 4 Adenocarcinoma lung cancer - no mutations. 

Just to rewind, my mum was diagnosed Stage 3a NSCLC back in September 2016. She was given concurrent chemo radiation which allowed for surgery. She was meant to have a lobectomy but due to complications during surgery, the surgeon had to do a right pneumonectomy (this was March 2017) Spending a lot of months in and out of hospital after, she adjusted well to living one with lung. However, after a routine scan in July 2018, we learnt the cancer was back, affecting her remaining lung, left supraclavicular lymph node and possible mets to coealic nodes surrounding the stomach as well as thickening of chest wall on the right side of the chest (pneumonectomy side) 

Mum started immunotherapy Keytruda in August as she tested 60% for PD-L1. A scan in October showed growth but no new spread. Oncologist recommended 4 more rounds of Keytruda and scan again. She had a CT scan and we get the results of that tomorrow. I try to be positive but realistic too. If this scan shows continued growth or new areas, Keytruda will be stopped and a line of chemo will begin.

I appreciate everyone responds differently but is there any combos of chemo that people have had a good response to that are Adenocarcinoma? 

I’m aware we are not looking at a cure now but mum is doing well in herself - if we could just keep this awful disease stable for as long as possible that’s the next best thing for us.

Also, as previously mentioned, mum has no mutations (this was tested on first diagnosis in 2016) Is it worth asking if these can be tested again? Can cancer cells mutate afterwards? 

Thank you in advance & blessings to all,

AMay

[Tom Galli]

AMay,

I had a right pneumonectomy also and then about 8 months later, 3 tumors appeared in my left lung.  To address these, I had 12 infusions of Taxol and Carboplatin.  At that time (2004) these drugs were the standard of care for both adenocarcinoma and squamous cell NSCLC and my treatment eliminated 2 tumors and reduced the size of the remaining, stubborn one.  My oncologist was on the verge of putting me on a chronic disease protocol -- to keep my cancer in check when the FDA approved precision radiation (SBRT) for lung cancer.  Despite having already had conventional radiation, I was approved for precision radiation and it fried my tumor.  I've been no evidence of disease since March 2007.  In February, I will survive 15 years after diagnosis with advanced stage lung cancer; if I can live so can your mom!

I wouldn't know about repeat mutation testing but I'd give Keytruda a bit more time.  Mid treatment scan results are generally not as good as end of treatment scans.  Can cancer cells mutate after treatment.  Yes, and in fact, they can mutate during treatment but generally the mutations are to defeat conventional chemotherapy.  I don't know of a way cancer cells can mutate to avoid the immune system once identified as a foreign body during immunotherapy treatment.

Welcome here.  More questions?  This is the place.

Stay the course.

Tom

[Steff]

Hi AMay,

My mom has had both standard chemo cocktail for adenocarcinoma and then chemo + Keytruda  her recurrence a year later.  After 6 sessions of Keytruda + chemo, she went on to Keytruda only for a year.  As Tom said, it's pretty common to have "growth" on early scans.  This "growth" can be attributed to many things, but lots of times it is inflammation.  This was my mom's case.  At first glance, her CT showed what looked like cancer growth, but there were no cancer cells found and this growth was deemed to be inflammation/swelling from the tumor being attacked by the immune system.  This growth slowly started to recede, but is still present (all be it very small) over 1 year later.  Although we always want to hear "no evidence of disease", for most, it takes time to get there.  I will be keeping my fingers crossed for good news tomorrow.

Take care,

Steff