Hello @sboes...thank you! and Thanks Colleen!
Yes, Colleen is correct....my wife was diagnosed with Stage 4 Non Small Cell Lung Cancer (Multifocal Lung Adenocarcinoma HER-2/neu Amplified) in 2016 after her treatments were proven to not be working. She had undergone a bi-lobectemy of her right lung in May, 2015 followed by adjuvant cisplatin based chemotherapy.
CASE HISTORY FOLLOWS:
The amplification of the Her-2 mutation was determined (October, 2016) by a genetic study of a lung biopsy from Foundation One in Boston.
Her oncologist at the time, then suggested a trial called "My Pathways". We signed her up and the drugs were given to her via infusions every 3 weeks, beginning in December 2016. The drugs seemed to hold her cancer at bay until March of this year (4+ years), at which time she was hospitalized with a blood clot in the lung and double pneumonia.
A followup in April with Mayo-Rochester after her release from the hospital resulted in us putting her on "Chemo Holiday" until August 31...at which time scans showed the cancer had now grown...so, in early October of this year she was given "systemic chemotherapy" which included a combination of carboplatin, pemetrexed (Alimta) and ipilimumab (YERVOY) plus nivolumab (Opdivo) similar to the check mate 9LA trial.
She was to have 2 cycles of carboplatin, pemetrexed with immunotherapy followed by maintenance immunotherapy only (ipilmumab, plus nivolumab). That therapy proved to not be working after the first 2 cycles.
Mayo now suggests we consider the possibility of being treated with trastuzumab deruxtecan (6.4 mg per kilogram of body weight) as per recent NEJM manuscript (September 18, 2021) that indicated an objective response seen in the 55% of patients with good tolerability.
We are now waiting for our local oncologist to discuss this proposal with Mayo, as we await approval of this phase 2 trial. The concern is that my wife had previously been on the My Pathways trial, which incorporated Herceptin and reintroducing that drug might cause toxicity in the lungs, much like what she experienced in March.
She has been on full time 02 since the latest hospitalization in October...
We have been told by our oncologists that this is the only viable alternative...So, we wait, and prayerfully hope for the best.
We are truly grateful for the additional time we have had together resulting from the latest advancements in medicine. We pray that the research will soon find a cure for this awful disease!