Stage 4 NSCLC

My mom was diagnosed with Stage 4 NSCLC in Sept. of 07. She also had tumors in the brain. She was given Radiation for the brain tumor and those shrunk and still seem to be to shrinking. To the point where the tumors are barely visible on the MRI. After Radiation on her brain she was given IV Chomo - Taxitol. I believe. After 2 rounds the tumor had shrunk about 30% and  after 4 rounds it only shrunk a small amount. They decided not to go any further with the chemo because of neuropathy in her hands and feet.  Yesterday we went back to check on the lung tumor. We were told not only had it grown but that she now had tumors in her liver. It has been recommended that she start a new oral chemo that is in phase 2 of clinical trials. The drug is called Pazopanib. My mom is pretty symptom free considering she has cancer. The only symptom she has right now is the Neuropathy. Here's are the questions. How bad are the side effects of this treatment? How will quality of life be effected by continuing treatment? Would it be better just to let the disease progress? I have always heard once it's in the liver it's just a matter of time....

[HeinrikMD]

Hi,

Pazopanib targets blood vessels feeding the cancer. Hence, the expected side effects would involve bleeding, hypertension, rash. There is some concern, as this agent is indeed still being investigated. For use in lung cancer, there is some concern. While there is an agent called Avastin that has shown good results when used with Chemo for patients who are have never received chemo, whether this will also be true if the Avastin was given for those who finished initial course of chemo is not known. Also, it is anticipated that the benefit of the drug may be better if used in combination with another drug – not use by itself. There is an observation in breast and colon cancers that drugs affecting the blood vessels seem to work better, when used during the first round of chemo.

There are agents that are available like Tarceva (whose main side effect is rash and diarrhea) that have been used in patients that have completed initial chemo There are two more agents that are also used for patients that have finished a first round of chemo, these drugs are docetaxel and pemetrexed.

You can discuss these other options with your doctors. Patients who have received prior chemo and then take a 2nd line agent on the average they have about a 7-9 month survival rate.

Stay positive.