Lung cancer progression on Tarceva with urgent T790M resistance testing planned

Patient Info: Anonymized, Male | Stage Metastatic/Advanced

Biomarkers: resistance suspected; bronchoscopy planned to test for it

As of January 2016, CT showed clear progression while he was taking Tarceva/erlotinib, so urgent bronchoscopy was planned to look for T790M resistance and guide the next treatment option.

EGFR-mutated NSCLC on Tarceva with CT follow-up pending and future resistance options discussed

Patient Info: Anonymized, Male

Biomarkers: EGFR mutation; T790M resistance discussed as a possible future resistance mechanism

As of December 2015, he was on Tarceva/erlotinib for EGFR-mutated NSCLC, had new cough/chest pain/fatigue, and was waiting for a control CT to clarify whether the tumor remained controlled.

Stage IV gastric adenocarcinoma causes inferior vena cava compression and severe leg swelling

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

Biomarkers: HER2-positive

Metastatic Site: omentum

At the latest follow-up, she was receiving cycle 5 of paclitaxel and trastuzumab. Her appetite, energy and leg edema had improved, although abdominal bloating persisted.

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Severe gastrointestinal bleeding and perforation during apatinib treatment for metastatic gastric cancer

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

Biomarkers: HER2 IHC 2+; FISH negative for HER2 amplification

Metastatic Site: peritoneum, ileum

She died on February 23, 2015 after gastrointestinal perforation, septic shock and multiple organ dysfunction during progressive metastatic disease.

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Metastatic Low-Grade Serous Ovarian Cancer Causing Severe Pulmonary Hypertension

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

Metastatic Site: pleura, pulmonary arteries

She died on hospital day 29 after rapidly progressive pulmonary hypertension. Autopsy attributed the pulmonary hypertension to metastatic ovarian serous carcinoma with pulmonary arterial tumor emboli.

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Lung cancer on Tarceva with stable symptoms during summer follow-up

Patient Info: Anonymized, Male

As of July 2015, he was continuing Tarceva, felt strong overall, had no major cancer symptoms, and was waiting until October for the next CT while assuming the tumor remained stable.

Lung cancer on erlotinib with side effects and CT results pending

Patient Info: Anonymized, Male

As of March 2015, he was continuing erlotinib/Tarceva, dealing with side effects and anxiety while waiting for CT results, and receiving support from readers and other patients.

EGFR-mutated NSCLC on Erlotinib/Tarceva with March CT pending

Patient Info: Anonymized, Male

Biomarkers: EGFR mutation; T790M discussed as a possible later resistance mutation

As of February 2015, he was about 1.5 months into Erlotinib/Tarceva for EGFR-mutated NSCLC and was waiting for a March CT to know whether the tumor was controlled.

Lung cancer on Erlotinib/Tarceva with rash, dyspepsia, mouth irritation, and fatigue

Patient Info: Anonymized, Male

As of January 2015, he had been taking Erlotinib/Tarceva for more than 15 days, was managing early side effects, and was waiting for the March CT to show whether tumor growth had stabilized and whether there was metastasis.

Lung cancer diary: starting Tarceva and treatment-cost concerns

Patient Info: Anonymized

As of January 2015, the patient had just started Erlotinib/Tarceva for lung cancer, with early mild side effects and ongoing uncertainty about response.

Stage IV Breast Cancer: Liu's Patient Story

Patient Info: Liu Jing | Stage IV

More than eight years after a stage 4 diagnosis, Liu Jing remained on hormone and targeted therapies and continued working, walking, and mountain hiking.

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Stage III low rectal cancer: complete response to mFOLFOX6 plus panitumumab and sphincter-preserving surgery

Patient Info: Anonymized, Male, 50s

Biomarkers: KRAS wild-type

As of March 2014, he was alive without evidence of recurrence 3 months after surgery, after complete pathologic response to neoadjuvant mFOLFOX6 plus panitumumab followed by intersphincteric resection and adjuvant UFT/leucovorin.

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EGFR exon 19 lung adenocarcinoma with bone and brain metastases: brain lesions resolved on gefitinib

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

Biomarkers: EGFR exon 19 deletion

Metastatic Site: lumbar spine, pelvic bone, brain (left occipital lobe,…

As of March 2014, asymptomatic brain metastases had regressed after 1 month of gefitinib and were no longer discernible after another 3 months, while lumbar vertebral disease was treated with radiotherapy.

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Stage IIIA NSCLC with superior vena cava tumor thrombus: complete response to radiation and erlotinib

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

Biomarkers: EGFR protein expression positive; EGFR gene mutation not tested because tumor sample was inadequate

Radiation plus erlotinib led to complete response of the primary lung tumor at 6 months, disappearance of the SVC thrombosis at 9 months, and no progression during 45 months of close follow-up on maintenance erlotinib.

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Sigmoid colon cancer: complete response after repeated metastatic recurrences and multimodal therapy

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

Biomarkers: KRAS/NRAS/BRAF status not reported; CEA elevation used for recurrence monitoring

Metastatic Site: left lung, mediastinal lymph nodes, left adrenal…

By 2011, all metastatic lesions had achieved complete response; nearly 1 year after the last adrenal irradiation, no recurrence had been detected.

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EGFR L858R-mutant Stage IV lung adenocarcinoma managed after gefitinib-induced lung injury

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

Biomarkers: EGFR L858R mutation

Metastatic Site: liver, bone, hilar lymph nodes, mediastinal lymph…

Gefitinib produced early tumor shrinkage but was stopped for interstitial lung disease; subsequent carboplatin, pemetrexed, and bevacizumab produced a good response, while variceal bleeding was controlled with endoscopic treatment.

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Stage IV lung squamous cell carcinoma with liver metastasis treated with chemotherapy and 90Y radioembolization

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

Metastatic Site: liver

After treatment for liver metastasis, PET CT 2 months after 90Y radioembolization showed complete tumor response without residual tumor, and she was alive without active disease.

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Recurrent Stage III Ovarian Cancer in a BRCA1 Carrier Treated With Multiple Therapies

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

Biomarkers: BRCA1 mutation

By late 2011, hilar nodal disease was slowly progressing and bevacizumab was started for the recurrent ovarian cancer.

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Recurrent Stage III Ovarian Cancer Complicated by Severe Kidney Injury

Patient Info: Anonymized, female, 70+ | Stage III

After further intra-abdominal cancer progression and severe kidney injury, she developed seizures, encephalopathy, and limb ischemia and died 1 week after hospitalization in May 2011.

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Recurrent HER2-amplified breast cancer: complete remission on trastuzumab-based therapy

Patient Info: Anonymized, Female, 40s | Stage Metastatic/Advanced

Biomarkers: Primary tumor was ER/PR negative and HER2 not amplified. Recurrent lymph-node disease became ER/PR positive and HER2 amplified by FISH.

Metastatic Site: left axillary and infraclavicular lymph nodes

After HER2-amplified nodal recurrence, paclitaxel plus trastuzumab produced complete clinical remission; she continued trastuzumab monotherapy with tolerable neuropathy.

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Sigmoid colon cancer with later inguinal lymph-node metastasis: surgery, FOLFOX, FOLFIRI, and cetuximab

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

Biomarkers: CEA was elevated at diagnosis and recurrence. Metastatic lymph node was CK20 positive/CK7 negative; EGFR mutation status not reported.

Metastatic Site: left inguinal lymph node

Apparently disease-free 8 months after surgical removal of the left inguinal lymph-node metastasis followed by FOLFIRI plus cetuximab.

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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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Stage IV NSCLC with choroidal metastasis responding to intravitreal bevacizumab

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

Metastatic Site: choroid of right eye

The right-eye choroidal metastasis showed complete local response after intravitreal bevacizumab, with pain resolution, vision improvement to 20/20, and no residual ocular tumor detected 10 months after treatment began.

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Stage IV Breast Cancer: Su's Patient Story

Patient Info: Su Chiao | Stage IV

Metastatic Site: bones, thymus, liver

After 7 years, the breast cancer had spread to the bones and thymus, and more recently it spread to the liver, where she underwent embolization.

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