Diane White, a 68-year-old, was diagnosed with stage III non-small cell lung cancer in late 2019 after experiencing persistent bronchitis. Unable to undergo surgery, she sought treatment at MD Anderson Cancer Center, drawn by its reputation and comprehensive cancer care. Her journey involved multiple clinical trials and targeted therapies, significantly impacting her prognosis and quality of life.
Initial Lung Cancer Treatment and Progression
Upon arrival at MD Anderson, Diane enrolled in a clinical trial involving the immunotherapy drugs nivolumab and ipilimumab, combined with 30 rounds of radiation therapy. Despite initial treatment, the lung cancer metastasized to her brain, advancing it to stage IV. Subsequent interventions included Gamma Knife stereotactic radiosurgery and a craniotomy to remove brain metastases, also conducted within the framework of a clinical trial.
Targeted Therapy Based on Molecular Analysis
Molecular analysis of Diane's lung cancer revealed a mutation in the Epidermal Growth Factor Receptor (EGFR) gene, specifically exon 21 L858R. Consequently, she was started on osimertinib, a targeted therapy drug and EGFR-targeted tyrosine kinase inhibitor, as part of another clinical trial. Osimertinib functions by blocking the signals from EGFR that promote tumor cell growth and multiplication. This targeted approach proved effective in controlling the lung cancer's progression.
Subsequent Cancer Diagnoses and Management
In May 2021, a CT scan revealed a second primary cancer: breast cancer. While this precluded her continuation in the current clinical trial, she remained on osimertinib for her lung cancer. A lumpectomy and radiation therapy were performed to address the breast cancer. In February 2024, another Gamma Knife procedure was performed to treat a suspicious area on her brain, with no issues reported since.
Managing Side Effects and Maintaining Quality of Life
Currently, Diane is not enrolled in any clinical trials but continues to take osimertinib daily. She manages side effects such as nail changes, acid reflux, and diarrhea with medication and lifestyle adjustments. Diane emphasizes the importance of maintaining a positive attitude, inspired by her mother's resilience, and focusing on legacy-oriented goals. Regular checkups and scans at MD Anderson ensure ongoing monitoring and prompt intervention if needed. She remains grateful for the care she receives, stating, "Knowing I’m at the best place possible to treat cancer gives me hope."
