Week 22 - Progression in the lung and fatigue

Written by Lars Haakon Soraas

Week 22 in the war on cancer. Could have been much better. Here we are:
-On Monday we learned, as we suspected, that there is also progression in the lungs. We hence have both progression in the brain and in the lungs. The good news is that no new lesions can be seen on the scans.
-As Dyanne has tested positive for the common resistance mutation T790M, the plan is to switch to a third generation tyrisine kinase inhibitor called Tagrisso (AZD9291). We hope to get this on compassionate use/extended access and we hope to get it soon.
-Furthermore, stereotactic radiation of the lesion in the brain is also a quite likely option.
-We are also looking into microwave ablation of the small lesions in the lungs. We are in contact with a clinic in London about this.
-Dyanne has been very tired this week. We first thought it was due to disulfiram and she stopped this. This did not help, however, and we then suspected it was due to itraconazole increasing the concentration of erlotinib in the blood (itraconazole is a CYP3A4 inhibitor and erlotinib is metabolized by CYP3A4). She stopped itraconazole and also erlotinib for one day. This seems to have helped.
-Still some cough, but not very much.
We just learned today that Abigail, a patient similar to Dyanne that we met in London last year, passed away yesterday. We have had quite a lot of contact with her husband, Stefano, who, like us, have actively looked into promising treatment options. We are deeply saddened to hear this news. Abigail was 39 years old and is leaving behind Stefano and their two young children.
Regarding my post a couple of days ago on CRISPR/Cas technology and how this can be used to treat lung cancer: if you, or someone you know, are thinking of taking a one-year sabattical and would like to lead a project where the target is to implement the published blueprint for how this technology can be used to treat EGFR positive lung cancer, then do contact me. The position will involve a lot of travelling and dialogue with leading scientists and doctors in the area. It will most likely be uncompensated (incurred travel costs will hopefully be covered). Good project management skills, English knowledge and drive are the most important qualifications.
Thanks to Niki as always (list of things to thank her for this week is too long to repeat here), to brother Arne for SEG-CUSP follow-up and Richard Kast the same, and to my mother, Anne Berit, for cooking and babysitting.

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