The Bad and the Possibly Good

So on Tuesday my Mom and Marty took a trip to the National Institute of Health in Washington DC. On the way to the appt, Mom's oncologist and gave her some bad news about the previous days CT scan. The tumors have increased by 50% in size since the last scan ~6 weeks ago. So the Tarceva (expensive daily chemo pill with very limited side effects) is not working, and mom has since stopped taking it. However, at the NIH mom got some possibly encouraging news. She was seen right away and the doctors were friendly. They diagnosed her cancer as an undifferentiated non-small cell neuroendocrine tumor. They are currently carrying out a clinical trial with a drug (PF-00299804) for Non-small cell lung cancer patients after failure of a chemotherapy and Tarceva. The new drug is very similar to Tarceva, in that it is taken orally has similar side effects, and it blocks three growth factor receptors, including the one that Tarceva blocks. It is a phase II clinical trial and only 74 people will be enrolled and they have some data from the first 47 patients. In order to participate, Mom will have to make several visits to the NIH to get blood work and tests to evaluate the drug. If the drug doesn't work, she will be able to leave the study and start another chemo regimen if she wishes.
In order to be eligible for the study she has to be KRAS wild-type so they need to do some genetic testing, she also has to be off the Tarceva for two weeks. In order to do the genetic testing she needs unstained tumor tissue. They found some at the Reading Hospital, but Mom opted to get a re-biopsied at the NIH. We are hoping they will re-analyze her tumor diagnosis as well, since through-out her treatment they have been treating her cancer as a small cell lung cancer, but it has been diagnosed by NIH and Fox Chase as non-small cell neuroendocrine.
Once we get the results from the Biopsy, and assure mom is eligible for the study, we will have to make the decision if we want to participate or not. The dr's told us that people who have not responded to the Tarceva have responded to the new drug; however I am concerned that the tumor types of the responding patients are adenocarcinomas and not neuroendocrine tumors.
I'll keep you updated about how Mom's Biopsy goes today, and also Mom will be going to Sloan-Kettering on Monday to see if they have any more advice/clinical trials available.