New Biological Insights and Recent Therapeutic Advances in the Management of Lung Cancer: A Clinical Investigator Think Tank
A woman with ALK-rearranged, advanced NSCLC who received full-dose ceritinib for 2 years
1:53 minutes.
TRANSCRIPTION:
DR LOVE: So Dave, you have a patient who’s receiving ceritinib, you say for 2 years. What’s this lady’s situation? DR SPIGEL: Yes, it’s interesting. This is a very sweet woman from Mississippi who had been on crizotinib for a year under another provider’s care and then was progressing. And so came to get access to what was LDK at that time, or ceritinib. So the day we were getting her started on treatment, we got a screening image or MRI of the brain. And so she had a solitary lesion there with no edema. The trial fortunately allowed her to go on the study and just watch that closely, and so now it’s been about 2 years. We’ve watched that very closely. She’s at full dose. She refuses to come down, even though we spend 80% of our visit talking about GI toxicity. She will not let me dose reduce her. DR LOVE: What exactly is she experiencing? DR SPIGEL: It’s diarrhea while she’s out and about with her friends and her family and then nausea, periodically. She tries the nighttime dosing. We take it with food, et cetera. She just will not let me tinker with it. DR LOVE: What’s her lifestyle like? DR SPIGEL: You could see her on the street, would never know she’s going through cancer treatment. DR LOVE: And what’s going on with the brain met? DR SPIGEL: So finally, in this last scan, because we do watch that closely, she was complaining of a mild headache. And the lesion has gone from just a few millimeters to now just under 2 centimeters with edema. So she was allowed to stay on study when ceritinib got approved. But now she’s getting SRS to that lesion in Mississippi. And I’m just treating her with ceritinib off study. DR LOVE: And where else does she have disease? DR SPIGEL: So she had thoracic disease. She had hepatic lesions as well. DR LOVE: And those were progressing? DR SPIGEL: Yes. She’s basically in a CR. DR LOVE: So, they were progressing on the crizotinib, and she went into CR. The brain thing stayed stable for a long time and now is increasing? DR SPIGEL: That’s correct. |