April-2003
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Diagnosed with stage II breast cancer
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Surgery and adjuvant chemotherapy (adriamysin/cytoxan, and weekly docataxel)
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na
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March-2007
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Developed liver, lungs, lymph nodes, and skeletal metastases
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Chemotherapy (gemcitabine/docetaxel with concurrent IV trastuzumab/zoledronic acid), resulted in clinical remission
|
na
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April-2010
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Loss of hearing and left facial with recurrence in left internal auditory canal and LM
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Cyberknife therapy for IAC tumors and chemotherapy (lapatinib/capecitabine), resulted in significant improvement in neurological symptoms and imaging
|
na
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October-2010
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Ommaya inserted
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Experimental IT trastuzumab (5 mg flat dose per week)
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12.3
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January-2011
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New parenchymal, thoracic and lumbar LM metastases with additional 5th cerebral nerve and c1 lesions
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Whole brain and spine radiation and increased IT trastuzumab (10 mg per week)
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12.6
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July-2011
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Worsening intramedullary c1 lesions
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One month of IT trastuzumab (50–80 mg per week) and maximal dose of cyber knife therapy
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32.8
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March-2013
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Developed weakness in left hip/leg and enhancement in previously stable thoracic and lumbar lesions
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Increased total dose of IT trastuzumab (50–80 mg BIW, dose divided twice per week) administered by lumbar puncture and ommaya reservoir injections
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40
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May-2013
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No discernable change in disease progression
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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
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59
|
June-2013
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Diagnosed with meningitis
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Extended antibiotic treatment for two plus months (vancomycin)
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58
|
July-2013
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Hiatus from IT with an increase in CA27.29
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T-DM1
|
37
|
August-2013
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Removed ommaya
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50
|
September-2013
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New ommaya inserted
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Restarted IT trastuzumab (40 mg per week)
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50
|
October-2013
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Worsening neurological symptoms
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IT trastuzumab 50 mg (100 mg per week)
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40
|
August-2014
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Patient expired
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40
|