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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Better Medications For Advanced Lung Cancer

Hello; My husband has advanced NSCLC and he as received Carbolplatin/Gemceitbine as 1st line treatment. Followed by RT. I am researching the best 2nd line treatment for him. I am down to 2. I am comfortable with. 1. Docetaxel or 2. Nivolumab. I just dont know which one to pick. He has a patient status of 0-1. He is symptomatic with only pain where his cancer is. his vitals are and have always been great. he had no problems with the 1st line therapy and no problems at all with the RT to his lungs, lymph node, ribs and ischial tuberosity. We had his sample sent to MIPROFILE and results were confusing. One page says EGFR pos. and another says EGFR wild type. Since the sample came back EGFR neg. the first time and he has squamous cell, I m assuming its wild type. The oncologist is also confused. 3 weeks ago, she suggested docetaxel but now she is suggesting the Nivolumab. I guess my question is: Since Nivolumab has not been studied as a combination therapy with another chemo drug for NSCLC, is there another drug you might suggest in combination with Nivolumab? for 2nd line treatment? Is there a drug like Ramucirumab but that has been studied and prescribed for squamous cell?
Mon, 21 Sep 2015
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Oncologist 's  Response
Hello dear. I have gone through your details. Nivolumab is a recently available drug and has better safety and survival profile and thus qualifies as first drug to use in good status patients. It has to be used as single agent. Later on if your husband shows progression, docetaxel can be used along with ramucirumab. i think your doc is right in suggesting nivolumab. Hope i have made you understand now. Thanks
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Suggest Better Medications For Advanced Lung Cancer

Hello dear. I have gone through your details. Nivolumab is a recently available drug and has better safety and survival profile and thus qualifies as first drug to use in good status patients. It has to be used as single agent. Later on if your husband shows progression, docetaxel can be used along with ramucirumab. i think your doc is right in suggesting nivolumab. Hope i have made you understand now. Thanks