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What happens after Tagrisso?


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I am here because my mother was recently diagnosed with efgr+ exon 19 lung cancer. She couldnt handle the tarceva side effects so her new oncologist has now put her on tagrisso. She is in her early 70s.
Tarceva did work and her primary lung tumor reduced in size and she received srt for her brain mets. Recent pet scan after two months showed no new brain mets and no new tumors. 

What happens when there is progression on tagrisso? Are there new drugs? Also her oncologist said they dont give immunotherapy for egfr positive patients. The new doctor told us he does not recommend tarceva first because theres only a 50% chance of developing the t790m mutation which makes tagrisso effective as 2nd line. 

Any testimonies and advice is much appreciated. 




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Hi Rowan, I am 67 and also have EGFR + exon 19 lung cancer and have been taking Tagrisso since March as a second line treatment after chemo and radiation. It's been very effective for me and I luckily have no side effects from it. 

Basically you take Tagrisso until it stops working or becomes toxic. How long that takes is different for every person. I don't let myself think about the what-ifs. I've learned to live in the present and hope that the scientists will come up with a second generation drug for us in the future. 

But congratulations to your mother on her recent scans! That's an excellent response. I hope she continues to improve. If she does have side effects, please let her oncologist know. 

Thanks for joining us. I'm sure others will welcome you too. 

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Thank you for the prompt reply. Her liquid biospy came back with a list of targeted therapies, chemotherapies, monoclonal antibodies and immunotherapy reccomendations. When we showed it to her new oncologist he said immunotherapy does not work for egfr positive patients.

Is this true? Has any egfr postive patients tried immunotherapy or monoclonal antibody therapy? 

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While I was still getting chemo, my oncologist considered putting me on the immunotherapy drug Imfinzi, but once chemo was finished, he reconsidered and settled on Tagrisso. My most recent PET/CT scan showed vast improvement from the prior 3 months. So I'm satisfied with Tagrisso and feel like it was the right decision for me. 

If feasible, you may also want to get a second opinion to ensure your comfort with the treatment plan. But to me, it sounds like your mother is responding to Tagrisso, and good for her! 

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  • 3 months later...

rowan, my mother was also diagnosed with egfr exon(21) last march. Almost a year to the day. She has been on tagrisso since April. as well as receiving gamma ray knife procedure for the metastasis in her brain. Since then the brain tumor is gone with only a small scar remaining. They can no longer find the cancer on her hip bones and her lung tumor has halved in size and then remained stable about half way through treatment. It's now driving me mad every time we go for her scan. To think that it remains stable instead of disappearing even at a slow rate, makes me frightened to think about when tagrisso will stop working. I know there are a few other options with other things on the horizon but my anxiety grips me like a vice every additional scan with no more improvement. I am also seeking answers to the next step so I can not feel so helpless and prepare. I get angry that the only place her cancer remains is in her lung now and they still consider her inoperable. I just can't comprehend why if the cancer has been eradicated outside of that, then why aren't we restaging it. Well here I am at 2 am again trying to find answers on the internet. How is your mom doing on her treatment?

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Please do yourself a favor and stop looking on the internet for answers.  Much of the data there on prognosis and longevity is done on a 5-year average and may not reflect the survival rates or new approaches of today.  Rather, speak to your Mom's team (with her permission, of course).  Ask them all of your questions.  If you're not satisfied with the answers you can always take your Mom to another doctor (oncologist) for a second-opinion.  This disease has very few straight lines.  It seems that doctors are aware of that and are constantly thinking about how to approach all the twists and turns that LC shows them.

Good luck in getting the information you need and I also hope you'll have more peace of mind.


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