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 Limited Disease Control Across Multiple Therapies

Patient Info: Anonymized, female

Biomarkers: ERBB2 V776delinsVC mutation

After temporary stable disease when bevacizumab was added to chemotherapy, the cancer progressed on trastuzumab plus paclitaxel and then erlotinib.

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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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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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HER2-Positive Right Breast Cancer With Complete Response Before Bilateral Mastectomy

Patient Info: Anonymized, female, 50s

Biomarkers: ER negative, PR negative, HER2 positive

After neoadjuvant treatment, imaging showed complete resolution of the right-breast mass and mastectomy pathology found no residual right-breast tumor or malignant right sentinel node.

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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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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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