Treatment Timeline

DateDisease ProgressionTreatmentSerum CA 27.29 (U/mL)
April-2003Diagnosed with stage II breast cancerSurgery and adjuvant chemotherapy (adriamysin/cytoxan, and weekly docataxel)na
March-2007Developed liver, lungs, lymph nodes, and skeletal metastasesChemotherapy (gemcitabine/docetaxel with concurrent IV trastuzumab/zoledronic acid), resulted in clinical remissionna
April-2010Loss of hearing and left facial with recurrence in left internal auditory canal and LMCyberknife therapy for IAC tumors and chemotherapy (lapatinib/capecitabine), resulted in significant improvement in neurological symptoms and imagingna
October-2010Ommaya insertedExperimental IT trastuzumab (5 mg flat dose per week)12.3
January-2011New parenchymal, thoracic and lumbar LM metastases with additional 5th cerebral nerve and c1 lesionsWhole brain and spine radiation and increased IT trastuzumab (10 mg per week)12.6
July-2011Worsening intramedullary c1 lesionsOne month of IT trastuzumab (50–80 mg per week) and maximal dose of cyber knife therapy32.8
March-2013Developed weakness in left hip/leg and enhancement in previously stable thoracic and lumbar lesionsIncreased total dose of IT trastuzumab (50–80 mg BIW, dose divided twice per week) administered by lumbar puncture and ommaya reservoir injections40
May-2013No discernable change in disease progressionTrastuzumab (administered bimonthly for maintenance at 50 % of the weekly dose) and lapatinib (750 mg, BID five days weekly), resulted in decreased enhancement and activity of thoracic and lumbar lesions59
June-2013Diagnosed with meningitisExtended antibiotic treatment for two plus months (vancomycin)58
July-2013Hiatus from IT with an increase in CA27.29T-DM137
August-2013Removed ommaya50
September-2013New ommaya insertedRestarted IT trastuzumab (40 mg per week)50
October-2013Worsening neurological symptomsIT trastuzumab 50 mg (100 mg per week)40
August-2014Patient expired40

Na not available (patient at different clinic)