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Cancer Age Country 1st Diagnostic Status
Non Small Cell Lung Cancer 61 Bulgaria 2014 currently in treatment
See Dancho's report

Dancho, Non Small Cell Lung Cancer

Age Country 1st Diagnostic Status
61 Bulgaria 2014 currently in treatment

In October 2014 the patient (a 61-year-old male, never smoker) was diagnosed for a NSCLC stage IV.

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Detailed report

  • Oct 2014

    Diagnostic

    The patient was diagnosed for a NSCLC stage IV.

     

    Biomarkers already tested:

    – EGFR negative

    Previous treatments:

    – 3 cycles of cisplatin 150mg /gemcitabine 2000mg
    – 3 cycles of docetaxel 75mg

  • Apr 2015

    We received the sample more than one year after the first diagnosis and we performed an OncoDEEP on the original biopsy. On the contrary of what was found, we identified two activating mutations in EGFR.

    Recommended treatments:

    Approved for lung cancer : afatinib (from July 2015)

  • Jul 2015

  • Sep 2015

  • Nov 2015

  • Mar 2016

    3 OncoTRACE analyses showing the disappearance of the mutations. Confirmation by CT Scan.

  • May 2016

    After 12 months since the reception of the report, the patient is in complete remission and no variants have been so far detected in the blood which confirms the complete remission.

  • Aug 2016

    After 16 months of treatment with afatinib, the OncoTRACE#6 has revealed the presence of the EGFR acquired resistance mutation T790M (1%). Although this variant is known to appear after 1st (erlotinib) and 2nd generation (afatinib) Tyrosine Kinase Inhibitors (TKI) treatment, it has not been associated with resistance to second-generation TKI.

    Nevertheless, presence of this variant in the blood might indicate a relapse of the patient. A CT scan has been performed and no mass has been observed. Relapse could not been confirmed yet and the oncologist decided to continue with the current treatment.

    However a particular attention should be paid, involving a closer monitoring

  • Oct 2016

    The 7th OncoTRACE analysis showed no ct-DNA in the blood confirming the last PET Scan. The transitory increase of variant T790M might be the result of a micro metastasis.

  • Dec 2016

    However, the 8th OncoTRACE showed this time 3 EGFR mutations. This time, disease progression was confirmed by CT scan.

  • Mar 2017

    The patient is currently on Pembrolizumab since Osimertinib is not available now in Bulgaria. The patient seems to be answering well to the treatment since all the variants have disappeared in the blood as proven by the latest OncoTRACE.

  • Current status

    Because of the presence of a new EGFR variant, T790M, the treatment was modified to Pembrolizumab (osimertinib not being available in the patient’s country).

The testimonial

Dr Boris PETROV

OncoDEEP & OncoTRACE become a useful tools to understand the patient evolution and response to treatment.

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