Case Studies and Unique Examples
To better explain the cancer treatment approaches that I use for most of our patients integrated with their Immunotherapy program, I have included some success stories. Of course this does not occur for all patients, but the many who do benefit significantly and even what could be considered miraculously, makes me believe that it is worth pursuing as a therapeutic option.
Uterine cancer patient with liver and peritoneal metastasis found following initial surgical resection. Targeted tumor pathology results showed significant estrogen and androgen sensitivity. Treated with oral abiraterone(male and estrogen blocker) and afinitor along with an antiviral ribavirin(concurrently being studied at MD Anderson for HPV positive cancers alone as a single agent). Disease h
Squamous cell cancer of scalp metastatic to multiple lymph nodes despite radical surgery. Pathology showed major sensitivity to EGFR and cMET and has been on oral targeted therapies with substantial improvement /reduction in lymph node sizes in just 1-2 weeks.
Breast cancer patient: Greater than 85% of tests performed for breast cancer patients have shown essentially 100% androgen receptor overexpression. This patient with ER negative status was treated with oral androgen blocker with subsequent major clinical response.
Relatively young male using high dose testosterone injections for body building and general increase in well being. Diagnosed with bladder cancer, underwent BCG, bladder tumor resections, but progressed to an advanced stage where they recommended bladder resection and standard chemotherapy with makeshift Neobladder creation. He deferred such a drastic approach and came to our center. Targeted tu
Young male diagnosed with a 16cm leiomyosarcoma tumor mass thought to originate from the IVC with innumerable lung metastases. Pathology testing showed Maximum Androgen receptor sensitivity and currently being treated with androgen blockers with positive clinical resopnse
Oral squamous cancer with extensive metastasis throughout head and neck : deferred radical surgery and standard chemoradiation. Responded partially to EGFR inhibitor but since the start of a cMET inhibitor has shown dramatic clinical improvement.
Young male with cholangiocarcinoma : unresponsive to gemzar x 6 months. Labwork showed markedly elevated blood growth hormone levels 18x above normal as well as EGFR overexpression. Given antigrowth hormone and EGFR blocker treaments with drop in GH level to near normal, and near complete resolution of 8cm liver tumor in 2-3 months
Diffuse inflammatory breast cancer throughout whole chest and upper abdomen refractory to standard chemoradiation: pathology showed EGFR overexpressin(not high ) but after start of oral EGFR inhibitor showed near complete resolution of breast/chest wall skin lesions visably noticeable in 1 day lasting for about 4 months.
Esthesioneuroblastoma sinonasal cancer(extremely rare cancer) causing massive facial deformity/disfigurement. Pathology tested positive for sensitivity to androgens(AR), NSE(suggesting neuroendocrine differentiation) VEGF, TS(a negative test suggests sensitivity) treated with oral therapies against these specific targets with substantial improvement still over 2-3 years.
Pancreatic cancer: Urea breath test for H. pylori positive. Recent studies show strong evidence that H. pylori may be involved in the pathogenisis for most GI cancers (stomach, colon and pancreatic among other even non-GI related cancers). Treated successfully with now negative H. pylori status. Pathology did show sensitivity to cMET, EGFR, and TS and treated with multiple targeted therapies wit
Stage IV breast cancer patient : Labwork revealed 5 abnormally elevated "tumor markers" which were monitored serially and has been fairly accurate in monitoring her treatment response. Along with Her2/neu and ER/AR overexpression, TS findings various regimens of oral targeted therapies used have resulted in significant improvement and then relative stabilization for over 2.5 years.
Stage IV cholangiocarcinoma: positive for neuroendocrine differentiation (SSTR2+, NSE +) AR and TS. Treated with octreotide/sandostatin and other targeted therapies with continued marked clinical improvement.
Breast cancer: markedly advanced breast cancer throughout the bony skeleton. Pathology showed TS sensitivity. Treated with an oral targeted therapy with near complete resolution of all bone lesions in 2-3 months by PET scan and still alive after 9 years (lost contact- but located on google and a survivor now)
Breast cancer patient with abnormally elevated prolactin levels in postmenopausal elderly female. Treated with bromocriptine with normalization of prolactin levels and marked reduction in disease. Prolactin is thought to suppress the immune system which prevents it from recognizing cancer cells.
Breast cancer patient: pathology showed SSTR2 /NSE positivity confirming extremely rare neuroendocrine differentiated breast cancer. Currently being treated with a somatostatin analogue with significant positive response.
Stage IV breast cancer : showed TS and ER sensitivity, treated with a combination of targeted treatments, with near complete resolution of all lesions over 2 years. Found to have several tumor markers which were serially monitored and correlated with clinical status.
Mesothelioma stage IV: Pathology revealed cMET/EGFR overexpression, currently being treated with oral targeted therapies with marked improvement in symptoms and disease status.
Stage IV nasopharyngeal cancer. Upon treatment with regimen of targeted therapies, LDH tumor marker showed a marked "spike" or flare phenomenon with subsequent drop corresponding to marked clinical response.
Modern marvels of new state of the art "genomic" testing is now the standard which is used to "personalize" and guide treatments for the individual patient. How are accurate are they?
Despite "negative" MET exon deletion analysis but markedly overexpressed cMET protein in tumor cells, patient treated with cMET inhibitor with significant clinical response
Treated with an ALK inhibitor with significant clinical response despite "negative" ALK Rearrangement study, but based on markedly positive IHC overexpression of ALK protein in tumor cells
CMET and EGFR staining showed "positive" overexpression of targeted proteins/recepotrs yet standard guidelines used to determine use of treatment on DNA genomic testing were ngeative.
Patient treated wtih both EGFR and cMET inhibitors with significant clinical response.
cMET and EGFR "POSITIVE" overexpression seen on tumor slide IHC stains, yet genetic studies negative.
Patient treated with EGFR and cMET inhibitors with significant clinical response.