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Re: Multiple lung nodules any idea?
Hi,
I'm a lurker on these boards, and I haven't dealt with lung mets ... but looking at your profile, there may be a couple of things you could discuss with your onc:
Have you had tumor tissue sequenced (e.g., via the Caris or Foundation Medicine tests)? If you have tissue stored or could get new tissue, and you haven't had the test, it might be a good idea to try it. For example, if you find a PI3K mutation, Afinitor may be effective, particularly in combination with chemo (mutation aside, the BOLERO-3 trial showed good results when combining Afinitor with Herceptin and Navelbine). Afinitor is on-label for hormone-positive breast, but if you had the mutation, insurance may be more likely to pay for it. I believe the reports from Caris and Foundation will show all the markers for which you test positive, even if there are no approved drugs for that target yet - so you can use those results to search for studies for investigational drugs on Clinical Trials.gov.
On traditional chemo, it looks like you haven't had irinotecan, which is not used super commonly in breast but could be something to try in combination with Herceptin. Carboplatin if you want to revisit the platinum agents, and Taxotere if you want to revisit the taxanes, could be options. Avastin is one of those mysteries where it works amazingly for some people, even in breast, and we just don't know for whom or why. For me personally, I probably wouldn't roll the dice on Avastin if I weren't also combining it with a chemo agent.
Depending on where you're located and if you're open to joining a trial, I've heard good things about ONT-380 and liposomal doxorubicin (called MM-302). But there are lots and lots of trials out there.
Good luck, and keep us posted,
Lauren
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