Q. What do you think about GemCarbo chemotherapy?

Answered by
Dr. Bharat Patodiya
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 10, 2016 and last reviewed on: Oct 19, 2019

Hello doctor,

My mother has been diagnosed with stage 4 adenocarcinoma. She was having trouble breathing due to pleural fluid buildup. As per our oncologist's suggestion we have started Gemcitabine-Carboplatin chemotherapy before 10 days. The suggested course of treatment is six cycles of chemotherapy. As the test for EGFR mutations was not successful, the doctors did not suggest Erlotinib based treatment such as Tarceva. Can we switch to Erlotinib after two cycles of chemotherapy without knowing whether EGFR is positive or not?

Dr. Bharat Patodiya

General Medicine Internal Medicine Medical Oncology


Welcome to icliniq.com.

I can understand your anxiety.

  • By the EGFR (epidermal growth factor receptor) not been successful, do you mean that the test was not positive for mutations or it could not be performed due to inadequacy of the sample? Please clarify.
  • Starting EGFR inhibitors in the absence of mutation is not recommended as there will be no benefit and the patient will lose important time in which she could have received chemotherapy.
  • If the sample is inadequate and it is strongly recommended to get a rebiopsy, then continue chemotherapy till then.

Revert back with the answer to the above question to a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

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Thank you doctor,

Biopsy was done twice, but the tissue sample was not adequate to do further studies. So, doctors suggested to just continuing with chemotherapy. What do you think of the GemCarbo chemotherapy? Will that be effective? What else can we do to improve life expectancy? Our doctors are giving 6 to 9 months. What do you say?

Dr. Bharat Patodiya

General Medicine Internal Medicine Medical Oncology


Welcome back to icliniq.com.

  • GemCarbo is a decent option, since Pemetrexed cannot be given due to pleural effusion.
  • If it is stage IV, then there are usually ample number of sites from where an adequate sample can be taken like liver if she has a gross plural effusion, even that can be tapped and send for tissue block formation.
  • That tissue block can be used to study genetic analysis. This is much less invasive than deep tissue biopsy and commonly practiced. Patients are more compliant to this.
  • If it is possible on your part, then send the PET CT or CT report. We will discuss with our interventional radiologist about the adequacy of the sample site.

Revert back with the reports to a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

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