Thank you for your advice. I will revisit with the pdf you sent me. If Pembro works as well with less side effects, then I am going to research that. Hoping Friday is a good day for you!🤞

The PD-L1 negative and "no targeted mutations" rules out immunotherapy as the first line treatment for your mom. I have the same diagnosis as your mom, except I have a low positive percentage of PD-1 response, so I was treated with chemo-immunotherapy. It was a bag of Keytruda (immunotherapy), a bag of Paclitaxel (Taxol), and a bag of Carboplatin. Paclitaxel is an agent like Docetaxel and caused me severe joint and ligament pain, besides a few other side effects. They put me on Oxycodone for the last 9 weeks of the chemotherapy so I could complete 4 cycles. 6 weeks after my last chemo session the PET/CT showed no active cancer, only evidence of the tumors dissolving.
How old is your mom. The side effects can be a challenge. Some folks can't get through it. How many cycles (infusions) is she scheduled for? She should try to muscle through it. Tell her doctors about any troubling side effects. There are things they can give her to help. With Docetaxel, I read you have to watch for adverse neurological effects.
If you were thinking radiation instead of chemo, I wouldn't take that much radiation on my lungs. I had 35 sessions for throat cancer in 2020 and I still suffer from side effects. I can't imagine what it does to the lungs, ribs, and muscles in that area.

Are you taking her to all of her appointments? Somebody should be there to ask questions and write down what the doc says.
Bless you and your mother!
Stay positive!
Tony

@A MyLungCancerTeam Member Per clinic notes, stage 4 NSCLC squamous cell carcinoma. PD-L1 negative. Foundation 1 testing. Tumor mutational burden 1. Rest of markers negative. Liquid biopsy Jan 2024 showed no targeted mutation. No spread to other organs. Lungs only.
I am still trying to decipher the guide you sent, and I thank you for that.

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I treat my tablet which I have to take every morning (Osimertinib) as my best friend. I pick it up and talk to it and just before I swallow I ask what side affects are you going to throw at me today. Lol 😆 I'm not mad but it helps.

Hi,
There are only so many treatments approved for each different type of cancer and stage it was when diagnosed. Your mother obviously has metastatic cancer (stage 3B or higher), meaning it is in more than one lung and is in the lymph nod(s) and/or distant organs or bones. Metastatic cancer has to be given systemic treatment, which was chemo as the first line treatment. Now immunotherapy is approved as first line treatment of certain types of cancer that have certain types of genetic mutations or biomarkers.
Do you know what type of NSCLC your mom has and does it carry any genetic mutation or biomarker?
Here is an excellent PDF that tells you how everything works. There may be newly approved treatments available now that weren't approved when this was published.
https://www.nccn.org/patients/guidelines/conten...
There are lists of questions to ask your doctors for each phase of the journey starting on page 48. The TOC has hyperlinks, the page numbers and titles are active links.
Chemo can be rough, but doesn't last forever and the side effects go away rapidly after treatment is done. Look at the side effect that are listed for Doxetaxel, paying close attention to the lists of side effects that call for medical attention.
Stay positive!
Tony