1. Diagnosis at unang paggamot ng kanser sa baga
Ang pasyenteng Lu ay na-diagnose na may lung adenocarcinoma at lymph node metastasis noong Agosto 26, 2005. Ang isang left lower lobectomy ay isinagawa noong Setyembre 22, 2005. Ang carboplatin na sinamahan ng taxotere ay ginamit 4 na beses pagkatapos ng operasyon. Noong Agosto 3, 2007, dahil sa pleural effusion, ang diagnosis ay nakumpirma na umuulit, at siya ay ginagamot sa Tarceva (ang bilang ng mga cycle ay hindi alam). Noong Enero 8, 2008, natagpuan ang pag-unlad ng kanser sa muling pagsusuri, at pagkatapos ay itinigil ang paggamot sa Tarceva at sinimulan ang paggamot sa Libita sa loob ng 16 na cycle. Kasabay nito, natagpuan ang vertebral hip metastasis at 4 na cycle ng Zetai ang isinagawa.
2. Sa unang pagkakataon na lumahok sa mga klinikal na pagsubok, ang kondisyon ay nasa ilalim ng kontrol.
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 pamamaga was suspected to be resistant to crizotinib. He stopped crizotinib on July 18, 2012.
3. Sa pangalawang klinikal na pagsubok, halatang nawala ang tumor.
On August 6, 2012, Mr. Lu participated in the AP26113 drug klinikal na pagsubok at Denver Hospital. In October, the PET examination showed that the tumor disappeared and the tumor sa utak decreased and became large.
4. Tuklasin ang mga bihirang gene mutations at umasa sa paglahok sa mga bagong klinikal na pagsubok
Muling pagsusuri noong Hulyo 2014, ipinakita ng PET sa buong katawan: Ang mga sugat sa utak ay karaniwang stable, at ang dibdib ay may malinaw na pag-unlad. Noong Mayo 12, 2014, ang pinaghihinalaang anti-AP26113 lymph (3 cells, pinakamalaking 1.1 cm) cultured cell lines ay isinagawa sa Massachusetts General Hospital at nagpatuloy sa pagkuha ng 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 immunotherapy 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.
