Optimum Timing of Immuno/Chemo and Targeted Radiotherapy?

My 50 year old wife has just been diagnosed with stage IV Adenocarcinoma (<3cm tumour on left lung) which has spread to the brain (6 mets known at present - MRI in two days). 

We had our first meeting with the oncologist today who has recommended a combination of immunotherapy (Pembrolizumab/Keytruda) and chemo (Pemetrexed & carboplatin) initially for 3 months on a 21 day cycle, followed by targeted radiotherapy once it is established if the tumours are shrinking. 

My question is what is the optimum timing / order of treatments - intuitively you'd think the radiotherapy should run concurrently with the immuno?  Or is it better to let the immunotherapy to run its course before the radiotherapy?

Really appreciate any advice - I'm learning as fast as I can but appreciate any views please!  Equally if you are aware of any emerging treatments that might  be worth considering do please let me know - thank you.

  • Hello Matt222

    I'm sorry to hear that your wife has been given this diagnosis. Understandably it's a difficult time for you both. 

    The oncologist is the best person to answer your question has they will have the results and notes in front of them to be able to take all this information into consideration when discussing treatment options. 

    However if you'd like to chat things through with one of our team of nurses then please do give them a call. They are available Monday to Friday 9am to 5pm on 0808 400 4040 (reduced service over Christmas). 

    Best wishes, 
    Jenn
    Cancer Chat moderator