Metastatic Breast Cancer With Liver Progression Treated Through Multiple Chemotherapy Lines

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

Biomarkers: Initial tumor: ER 90%, HER2 3+, Ki67 15%. Liver metastasis: ER 30%

Metastatic Site: pleura, liver

After several periods of response and later liver progression, she remained on active treatment with pegylated liposomal doxorubicin.

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Metastatic Breast Cancer With Bone and Liver Progression After Multiple Therapies

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

Biomarkers: Initial tumor: ER 80%, HER2 negative, Ki67 18%. Liver metastasis: ER 75%

Metastatic Site: bone, liver

After massive hepatic progression and liver failure, chemotherapy was stopped and she died on January 31, 2016.

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ERBB2-Mutated Stage III Lung Cancer With Liver Recurrence and Multiple Lines of Therapy

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

Biomarkers: ERBB2 exon 20 insertion

Metastatic Site: liver

After 6 months of disease control on vinorelbine plus trastuzumab, the cancer progressed in all sites and she chose hospice care.

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Stage IV ERBB2-Mutated Lung Adenocarcinoma Responding to HER2-Targeted Therapy

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

Biomarkers: ERBB2 exon 20 insertion

Metastatic Site: bilateral lungs

Afatinib showed a response after 1 month, but insurance denial required a return to trastuzumab-based treatment.

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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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ERBB2-Mutated Metastatic Lung Adenocarcinoma With Leptomeningeal Progression

Patient Info: Anonymized, male

Biomarkers: ERBB2 A775_G776 insYVMA mutation with amplification

The final treatment produced a mixed systemic response, but leptomeningeal disease developed.

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ERBB2-Mutated Metastatic Lung Adenocarcinoma With Treatment Intolerance and Progression

Patient Info: Anonymized, male

Biomarkers: ERBB2 A775_G776 insYVMA mutation

After poorly tolerated earlier regimens with stable disease, he developed symptomatic progression during 1 month of afatinib.

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ERBB2-Mutated Metastatic Lung Adenocarcinoma With Progression Across Multiple Regimens

Patient Info: Anonymized, male

Biomarkers: ERBB2 V777delinsVGSP mutation

After a brief period of stable disease on cisplatin plus docetaxel, the cancer progressed through erlotinib, gemcitabine and afatinib.

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Stage III Ovarian Cancer: Pam's Survivor Story

Patient Info: Pam Scarpino, female | Stage III

Pam had no evidence of disease in March 2010 after treatment for recurrence and remained in remission at the time of the story.

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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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Male Breast Cancer Treatment Complicated by Stevens-Johnson Syndrome

Patient Info: Anonymized, male, 60s

After the third chemotherapy cycle he developed severe Stevens-Johnson syndrome with disseminated intravascular coagulation and multiorgan failure, and he died after care was shifted to comfort measures.

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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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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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Mixed epithelial and mesenchymal metaplastic breast carcinoma: no recurrence 1 year after surgery and adjuvant therapy

Patient Info: Anonymized, Female, 40s

Biomarkers: Mixed metaplastic breast cancer: epithelial part ER/PR/HER2-positive; mesenchymal part ER/PR-negative with weak HER2. Ki-67 ~20%.

As of March 2014, she was doing well with no recurrence or metastasis 1 year after modified radical mastectomy, adjuvant CEF/Taxotere chemotherapy, and tamoxifen.

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Stage IV NSCLC: near-complete response despite severe docetaxel-induced diarrhea

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

As of October 2013, he had completed 6 cycles of weekly docetaxel-cisplatin with dose reduction and supportive care, resulting in a near-complete response.

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Breast invasive ductal carcinoma with coexisting inflammatory myofibroblastic tumor: disease-free after mastectomy, TAC, and tamoxifen

Patient Info: Anonymized, Female, Under 40

Biomarkers: Breast cancer: ER/PR-positive with HER2 2+ and p53-positive. Separate inflammatory myofibroblastic tumor had ALK/vimentin/actin/S-100 markers.

As of August 2013, she remained disease-free 2 years after modified radical mastectomy, 6 courses of TAC chemotherapy, and tamoxifen.

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Gastric adenocarcinoma spreads to the liver and esophageal mucosa

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

Metastatic Site: liver, esophageal mucosa

The metastatic disease progressed despite 3 cycles of second-line docetaxel plus cisplatin.

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Recurrent Ovarian Cancer With Tumor Lysis Syndrome After Chemotherapy

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

Metastatic Site: lungs

After 9 years of stable disease, the ovarian cancer progressed extensively and the first cycle of renewed chemotherapy was complicated by severe tumor lysis syndrome and multiorgan illness.

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Mucinous Ovarian Cancer Treated During Pregnancy

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

The woman and her baby were followed for more than 5 years, and the mother had no evidence of ovarian cancer recurrence during that period.

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Stage IV EBV-positive lymphoepithelioma-like lung cancer with brain metastasis

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

Biomarkers: EBV-positive by in-situ hybridization

Metastatic Site: brain, retroperitoneal/posterior mediastinal soft…

Remained well and disease-free 6 months after resection of the retroperitoneal/posterior mediastinal metastasis and 8 years after initial presentation.

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Stage IIIA pleomorphic lung cancer treated with surgery, chemotherapy, and radiation

Patient Info: Anonymized, Male, Under 40 | Stage III

Alive 14 months after surgery without evidence of tumor recurrence after complete resection, adjuvant chemotherapy, oral S-1, and radiation.

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Triple-negative glycogen-rich clear cell carcinoma of the breast: chemotherapy, mastectomy, and radiation

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

Biomarkers: Triple-negative breast cancer with glycogen-rich clear cell features; pathology stains supported breast carcinoma.

Asymptomatic and disease-free 14 months after surgery, additional chemotherapy, and 50 Gy radiotherapy for T4N0M0 triple-negative glycogen-rich clear cell breast carcinoma.

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Stage IV lung adenocarcinoma: partial responses to cisplatin-docetaxel and erlotinib, complicated by fistula

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

Biomarkers: Tumor genomic biomarkers not reported. EGFR testing result not reported; erlotinib was used as second-line therapy.

Metastatic Site: contralateral lung, pleura

Metastatic lung adenocarcinoma had partial response to chemotherapy and persistent partial response on erlotinib; after erlotinib was stopped for enterocutaneous fistula, she was alive and well without evidence of lung-cancer progression.

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