1. Diagnóstico e primeiro tratamento do câncer de pulmão
O paciente Lu foi diagnosticado com adenocarcinoma pulmonar e metástase linfonodal em 26 de agosto de 2005. Uma lobectomia inferior esquerda foi realizada em 22 de setembro de 2005. Carboplatina combinada com taxotere foi usada 4 vezes após a cirurgia. Em 3 de agosto de 2007, devido a derrame pleural, o diagnóstico foi confirmado como recorrente, sendo tratada com Tarceva (número de ciclos desconhecido). Em 8 de janeiro de 2008, o progresso do câncer foi constatado no reexame, e então o tratamento com Tarceva foi interrompido e o tratamento com Libita foi iniciado por 16 ciclos. Ao mesmo tempo, foram encontradas metástases vertebrais no quadril e foram realizados 4 ciclos de Zetai.
2. Na primeira participação em ensaios clínicos, a condição está sob controle.
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. No segundo ensaio clínico, o tumor desapareceu obviamente.
On August 6, 2012, Mr. Lu participated in the AP26113 drug ensaio clínico at Denver Hospital. In October, the PET examination showed that the tumor disappeared and the tumor no cérebro decreased and became large.
4. Descubra mutações genéticas raras e espere participar de novos ensaios clínicos
Reexame em julho de 2014, PET de corpo inteiro mostrou: As lesões cerebrais estavam basicamente estáveis e o tórax apresentava progresso óbvio. Em 12 de maio de 2014, as linhas celulares suspeitas de cultura de linfa anti-AP26113 (3 células, maior 1.1 cm) foram realizadas no Massachusetts General Hospital e continuaram a tomar 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 Imunoterapia 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.
