Stage IV ERBB2-Mutated Lung Cancer With Extensive Bone Metastases

Patient Info: Anonymized, female, 60s | Stage IV

Biomarkers: ERBB2 exon 20 insertion. A PIK3CA mutation was later detected at progression and considered a possible resistance mechanism.

Metastatic Site: bone

After progression on pemetrexed following several earlier treatment lines, she transitioned to hospice care.

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Stage IV ERBB2-Mutated Lung Adenocarcinoma With Brain Metastases and Multiple Targeted Therapies

Patient Info: Anonymized, female, Under 40 | Stage IV

Biomarkers: ERBB2 exon 20 insertion, exact sequence not specified. ERBB2 copy-number gain was identified during progression on afatinib.

Metastatic Site: brain, adrenal gland, liver

The final documented afatinib plus bevacizumab rechallenge produced a mixed response followed by liver progression after 3 months.

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Stage IV Ovarian Cancer: Diane's Patient Story

Patient Info: Diane Sarver, female | Stage IV

After about 7 weeks on the clinical trial, Diane's test results had normalized; she was entering her third year on treatment and planned to continue while it remained effective and tolerable.

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Advanced metastatic lung cancer with bone metastases, pneumonia, and worsening pain

Patient Info: Anonymized, Male | Stage IV

Metastatic Site: Bone

By March 2017, he described worsening metastatic lung cancer with bone lesions, recent pneumonia, severe pain, and concern that AZD9291 might no longer be effective.

Stage IV Colorectal Adenocarcinoma: Darrell's Survivor Story

Patient Info: Darrell Sawyer, Male | Stage IV

Metastatic Site: Liver

As of February 2017, Darrell had completed surgery, portal vein embolization, liver resection and chemotherapy for Stage IV sigmoid adenocarcinoma and was living with treatment effects including neuropathy, vision changes, weight loss and chemobrain.

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Stage IV HER2-Positive Breast Cancer: Sarah's Patient Story

Patient Info: Sarah, Female, Under 40 | Stage IV

Biomarkers: HER2-positive; BRCA and other known hereditary breast cancer genes not identified in family history discussion

As of January 2017, Sarah had been living for almost 3 years with recurrent Stage IV HER2-positive breast cancer and was receiving Kadcyla every 3 weeks.

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Metastatic signet-ring gastric cancer spreads diffusely to the thyroid and skin

Patient Info: Anonymized, Female, 70+ | Stage IV

Metastatic Site: thyroid, skin

She died 1 month after hospitalization after her condition worsened despite supportive care.

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Afatinib Controlled EGFR-Mutant Metastatic Lung Cancer After Erlotinib Caused Pneumonitis

Patient Info: Anonymized, female, 60s | Stage IV

Biomarkers: EGFR-mutant

Metastatic Site: contralateral lung, pleura

At the last follow-up, she remained on afatinib with stable metastatic lung cancer almost 3 years after diagnosis and no recurrence of the pneumonitis.

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Stage IV Breast Cancer: Debora's Patient Story

Patient Info: Debora, Female, 60s | Stage IV

Debora was living with metastatic breast cancer after Stage III disease treated with surgery, chemotherapy, radiation therapy, and targeted therapy; four years after surgery, she was told the cancer had metastasized and was on targeted therapy.

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Lung Cancer Immunotherapy Caused New Type 1 Diabetes

Patient Info: Anonymized, Male, 70+ | Stage IV

Biomarkers: No ALK, ROS1, KRAS or EGFR alteration was detected; CK7-positive; TTF-1-negative; PAX-negative; CK20-negative

Metastatic Site: Pleura

After 4 combination-treatment cycles, the right-lung nodules had decreased markedly and nearly resolved. He continued maintenance pembrolizumab every 3 weeks and remained on insulin with stable glucose control.

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Metastatic lung cancer controlled on AZD9291 clinical trial with tracheal narrowing under review

Patient Info: Anonymized, Male | Stage IV

Metastatic Site: Metastasis mentioned; site not specified in this entry

On 20 November 2016, the patient’s tumor and metastasis appeared controlled on AZD9291 and the disease was not considered progressive, though tracheal narrowing required closer review and earlier follow-up.

Stage IV Signet Ring Gastric Cancer Presenting With DIC and Severe Anemia

Patient Info: Anonymized, male, 70+ | Stage IV

Metastatic Site: bone marrow

His coagulation abnormalities and anemia improved after chemotherapy, and he was discharged in stable condition to continue treatment and oncology follow-up.

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Stage IV Lung Cancer: Bill's Patient Story

Patient Info: Bill Smith, Male | Stage IV

Biomarkers: Genomic testing performed; specific result not reported

Metastatic Site: Brain; liver; bone/humerus

As of October 2016, Bill was receiving immunotherapy every 2 weeks, all tumors had shrunk, chemotherapy had stopped and he reported markedly improved quality of life while living with Stage IV lung cancer.

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Metastatic lung cancer on AZD9291 with a left iliac bone lesion

Patient Info: Anonymized, Male | Stage IV

Metastatic Site: Bone: left iliac bone

On 18 September 2016, the patient was living with lung cancer on AZD9291 after MRI confirmed a solitary left iliac bone lesion suspicious for metastasis, with radiotherapy deferred and the next CT planned for November.

Lung Adenocarcinoma Metastatic to the Breast With Inflammatory Breast-Like Symptoms

Patient Info: Anonymized, female, 60s | Stage IV

Biomarkers: EGFR positive. Breast metastasis: TTF-1 positive

Metastatic Site: right breast

A PET scan after breast radiation showed no metabolically active cancer, but she died 2 months after the breast metastasis was diagnosed.

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Stage III Inflammatory Breast Cancer Diagnosed After Severe Breast Pain and Swelling Following Mammography

Patient Info: Anonymized, female, 60s | Stage IV

Biomarkers: ER negative, PR negative, HER2 highly positive

After later metastatic disease was found, she chose no further active treatment and died of progressive disease in 2012.

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Lung cancer on AZD9291 with tumor shrinkage and new suspected iliac bone metastasis

Patient Info: Anonymized, Male | Stage IV

Metastatic Site: Bone: left sacroiliac/iliac region

On 28 August 2016, AZD9291 had reduced the lung mass and stabilized nodes, but CT also showed a new suspected left iliac/sacroiliac bone metastasis requiring MRI workup.

Recurrent Gastric Cancer With Peritoneal Spread and Acute Hypertension During Ramucirumab

Patient Info: Anonymized, male, 70+ | Stage IV

Metastatic Site: peritoneum

Treatment was stopped after 2 cycles because of progression, no further cytotoxic treatment was started, and he died at home 19 weeks after the last chemotherapy.

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Stage IV Colorectal Cancer: Kim's Survivor Story

Patient Info: Kim Austin, Female, 50s | Stage IV

Metastatic Site: Liver

As of April 2016, Kim had completed 12 total chemotherapy rounds, tumor-removal surgery and ileostomy reversal, and she reported regaining independence and feeling healthy again; no explicit NED/cancer-free status was stated.

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Stage IV HER2-negative gastric adenocarcinoma complicated by acute arterial thrombosis during chemotherapy

Patient Info: Anonymized, Male, 70+ | Stage IV

Biomarkers: HER2-negative

Metastatic Site: peritoneum, retroperitoneal lymph nodes

After recovering from acute arterial thrombosis, he restarted cancer treatment with docetaxel and remained well without further complications at the latest follow-up.

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Stage IV gastric cancer with peritoneal metastases controlled for years with intraperitoneal chemotherapy

Patient Info: Anonymized, Female, 60s | Stage IV

Metastatic Site: peritoneum, bone

She had survived 5 years 2 months after diagnosis of peritoneal carcinomatosis, despite later suspected ovarian metastases, confirmed bone metastases and recurrent peritoneal disease.

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Stage IV Gastric Cancer: Rick's Patient Story

Patient Info: Rick Sabbides, Male | Stage IV

Rick’s CaringBridge journal was being used to share updates and receive support during his Stage IV cancer journey.

The 6th Opinion

Patient Info: Anonymized, Female, 50s | Stage IV

Her daughters were documenting her ongoing Stage IV cancer journey and their family experience.

Metastatic Ovarian Cancer Discovered After Recurrent Embolic Strokes

Patient Info: Anonymized, female, Under 40 | Stage IV

Metastatic Site: left axillary lymph node

She received 1 cycle of paclitaxel and carboplatin and died on day 54 of her second hospital admission. Her family declined an autopsy.

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