Weeks 195 & 196: trying PI3K and PARP inhibition

Written by Lars Haakon Soraas

Weeks 195 and 196 in the war on lung cancer have passed. Here are the highlights:

  • The development of tumor markers CEA and NSE made it clear for us that the cancer certainly is growing again. Charts are attached at the end of the blog post.
  • We have decided to try a combination of two drugs that we hope can help shrink the cancer. One of the drugs is an inhibitor of PI3K, which is relevant given that Dyanne’s cancer cells have a mutation in the PIK3CA gene (which is part of the PI3K family). The second drug is a PARP inhibitor (olaparib). The rationale for trying this specific combination is partly this study: Olaparib and α-specific PI3K inhibitor alpelisib for patients with epithelial ovarian cancer: a dose-escalation and dose-expansion phase 1b trial. And also this, this and this preclinical study. Dyanne has a mutation in the PTEN gene, and due to this, we are thinking that inhibiting only PI3K may not be enough, and hence the addition of olaparib as well.
  • Dyanne has generally been in good shape lately. However, some side effects are expected from this new drug combination. So far Dyanne has had some fatigue and also a bit of nausea. We hope side effects will be manageable.
  • We are still waiting for the results from the CT scan Dyanne did 3 weeks ago. To take so long to evaluate a simple CT scan is unconscionable. But I guess we have become used to it. We just know we cannot rely on our local “university” hospital to be good at certain things.
  • Dyanne also has done an MR scan of the brain. Hopefully we will get results of this in the not too distant future.

We will monitor CEA and NSE in the coming week and hope the PI3K and PARP inhibitors will help drive CEA and NSE down. If not, we may have to do another round of chemo relatively soon.

Hope everyone has had a good weekend!

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