Treatment Timeline
| Date | Disease Progression | Treatment | Serum CA 27.29 (U/mL) |
|---|---|---|---|
| April-2003 | Diagnosed with stage II breast cancer | Surgery and adjuvant chemotherapy (adriamysin/cytoxan, and weekly docataxel) | na |
| March-2007 | Developed liver, lungs, lymph nodes, and skeletal metastases | Chemotherapy (gemcitabine/docetaxel with concurrent IV trastuzumab/zoledronic acid), resulted in clinical remission | na |
| April-2010 | Loss of hearing and left facial with recurrence in left internal auditory canal and LM | Cyberknife therapy for IAC tumors and chemotherapy (lapatinib/capecitabine), resulted in significant improvement in neurological symptoms and imaging | na |
| October-2010 | Ommaya inserted | Experimental IT trastuzumab (5 mg flat dose per week) | 12.3 |
| January-2011 | New parenchymal, thoracic and lumbar LM metastases with additional 5th cerebral nerve and c1 lesions | Whole brain and spine radiation and increased IT trastuzumab (10 mg per week) | 12.6 |
| July-2011 | Worsening intramedullary c1 lesions | One month of IT trastuzumab (50–80 mg per week) and maximal dose of cyber knife therapy | 32.8 |
| March-2013 | Developed weakness in left hip/leg and enhancement in previously stable thoracic and lumbar lesions | Increased total dose of IT trastuzumab (50–80 mg BIW, dose divided twice per week) administered by lumbar puncture and ommaya reservoir injections | 40 |
| May-2013 | No discernable change in disease progression | Trastuzumab (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 lesions | 59 |
| June-2013 | Diagnosed with meningitis | Extended antibiotic treatment for two plus months (vancomycin) | 58 |
| July-2013 | Hiatus from IT with an increase in CA27.29 | T-DM1 | 37 |
| August-2013 | Removed ommaya | 50 | |
| September-2013 | New ommaya inserted | Restarted IT trastuzumab (40 mg per week) | 50 |
| October-2013 | Worsening neurological symptoms | IT trastuzumab 50 mg (100 mg per week) | 40 |
| August-2014 | Patient expired | 40 |
Na not available (patient at different clinic)