1. Diagnosis dan pengobatan pertama kanker paru-paru
Pasien Lu didiagnosis menderita adenokarsinoma paru dan metastasis kelenjar getah bening pada tanggal 26 Agustus 2005. Lobektomi kiri bawah dilakukan pada tanggal 22 September 2005. Carboplatin dikombinasikan dengan taxotere digunakan 4 kali setelah operasi. Pada tanggal 3 Agustus 2007, karena efusi pleura, diagnosis dipastikan kambuh, dan dia dirawat dengan Tarceva (jumlah siklus tidak diketahui). Pada tanggal 8 Januari 2008, ditemukan perkembangan kanker pada pemeriksaan ulang, kemudian pengobatan Tarceva dihentikan dan pengobatan Libita dimulai selama 16 siklus. Pada saat yang sama, metastasis tulang belakang pinggul ditemukan dan 4 siklus Zetai dilakukan.
2. Pertama kali mengikuti uji klinis, kondisi terkendali.
In July 2010, Mr. Lu reexamined a large area of brain metastasis and found dozens of small lesions in the brain. He also tested positive for the EML4-ALK fusion gene at the University of Chicago School of Medicine. The whole brain radiation therapy was then used to control the lesions, and the second phase of crizotinib drug trial was started at St. Louis University Hospital. During the treatment, the condition was stably controlled, but a re-examination in May 2012 found that the cancer had progressed slightly, and the tumor was suspected to be resistant to crizotinib. He stopped crizotinib on July 18, 2012.
3. Pada uji klinis kedua, tumornya hilang dengan jelas.
On August 6, 2012, Mr. Lu participated in the AP26113 drug uji klinis at Denver Hospital. In October, the PET examination showed that the tumor disappeared and the tumor di otak decreased and became large.
4. Temukan mutasi gen langka dan nantikan partisipasi dalam uji klinis baru
Pemeriksaan ulang pada bulan Juli 2014, PET seluruh tubuh menunjukkan: Lesi otak pada dasarnya stabil, dan dada mengalami kemajuan yang jelas. Pada tanggal 12 Mei 2014, garis sel kultur yang diduga anti-AP26113 (3 sel, terbesar 1.1 cm) dilakukan di Rumah Sakit Umum Massachusetts dan dilanjutkan dengan pengambilan AP26113.
In August 2014, the doctor called and found that Mr. Lu’s new tumor tissue sequencing detected rare or unseen mutations. This mutation was only reported in ALK-positive children’s neuroblastoma and inflammatory myofibroblastoma. Previous research reports and medical evidence have shown that crizotinib cannot cope with the resistant neuroblastoma caused by this mutation. New genetic test results indicate that Mr. Lu may need to find new drugs for treatment.
On December 8, 2014, after a doctor’s analysis and decision, Mr. Lu was approved to increase the dosage of AP26113 and changed it to 240 mg per day, so the drug replacement plan was temporarily delayed. After observing the efficacy, he decided whether to change the drug and participate in other clinical trials. The patient learned through the hospital that NIVOLUMAB monoclonal antibody imunoterapi phase 3/4 drug test is recruiting lung cancer patients on a large scale, and Mr. Lu is fully confident of the future anti-cancer.
