Skip to main content

Table 1 Treatment Timeline

From: Intrathecal trastuzumab: immunotherapy improves the prognosis of leptomeningeal metastases in HER-2+ breast cancer patient

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
  1. Na not available (patient at different clinic)