Now I open this new topic to share the treatment of another Chinese patient who has been fighting with ASPS for more than 7 years. Recently, she had PD-1 therapy combined with Cediranib and received really amazing results. I will firstly briefly describe her treatments before using PD-1 treatment because I cannot wait to share the unbelievable results with you!
She was diagnosed in 2008 (Found diffuse mets in lungs but cannot find the primary tumor). In June 2012, the primary tumor (8*6 cm) was found in her left thigh and removed in August 2012.
Following are the treatments before using PD-1:
In June 2012, the largest nodule in lung was 2.5*1.9 cm
In September 2013, the largest nodule in lung was 3.2*2.6 cm
In May 2014, the largest nodule in lung was 3.8*3.4 cm. And then 3 tumors were treated by using Cryoablation
In June 2014, the largest nodule in lung was 3.4*3.2 cm
In July 2014, 2 mets (1.2*1 cm and 4mm) were found in brain MRI scan and treated by Gamma Knife. Had lung infusion chemotherapy--several mets shrunk by several millimeters after two courses of treatment.
In August 2014, continued lung infusion chemotherapy--result showed disease progression, so stopped therapy.
In November 2014, two nodules under abdominal wall and scalp were removed. A nodule sized 0.9*0.7 cm was found in liver.
In December 2014, started taking Pazopanib . At that time, the largest tumor in lung was 4*3.2 cm
In Jan 2015, the liver tumor shrunk to 0.9*0.5. In Mar 2015, the largest nodule in lung grew to 4*3.6 cm; the liver nodule shrunk to 0.3 cm
In April 2015, new 8 nodules were found in brain Mri scan and all of them were treated by Gamma Knife.
Following is the PD-1 therapy combined with Cediranib:
In June 2015, scan results show:
Brain: the largest tumor was 0.8*0.7cm
Liver: 0.3 cm nodule
Pancreas: a 0.7cm nodule
Lung: the largest tumor was 5.4*4.5 cm (1.4cm growth in 3 months)
In June 2015, started taking Cediranib. After taking 16 days, the largest lung tumor shrunk to 5*3.9 cm
In July 2015, she started PD-1 therapy combined with Cediranib. After 4 times PD-1 therapy, she stopped the treatment due to serious side effects.
In Sep 2015, scan results show:
Brain: the largest was 0.8*0.7 cm and possible new nodules
Lung: the largest was 6*4.8cm (this largest was a fusion of small tumors), the rest tumors grew about 2-3 mm.
Pancreas: several nodules were found, the largest was 2.2*2.5cm
In 25 Sep 2015, she continued Cediranib
In Oct 2015, two new brain mets (6.6*5.2*5.4mm; 5.7*4.9*4.8mm) were treated with Gamma Knife
From Oct 2015, her overall condition has became much better: she had been suffered from cough for more than 2 years, but from that time, she does not cough at all. Appetite and physical strength have been improved a lot; her weight has gained more than 5kg till now; the blood oxygen goes back to 97 (which was stable at 85, even lower than 80).
In Nov 2015, her latest scan results show following:
Lung: the largest tumor shrunk to 2.3*2.7cm, total number of mets reduced .
Pancreas: the largest tumor shrunk to 1.7*1.8
Brain: overall, mets shrunk. can see cavity in tumors.
The main side effects:
Aggravated cough, feel weak and exhausted, diarrhea, sensitivity in mouth. And the patient developed fungal infection by testing phlegm after 4th PD-1 therapy.
It is the unbelievable result! Before PD-1 therapy combined with Cedirinib, she had hundreds of mets in her lung and many of them were larger than 2cm. Recent CT scan shows the largest is 2.3*2.7cm, the number of mets reduced and most tumors are smaller than 1cm. It is noticeable that after 4 courses of PD-1 therapy, it showed a significant disease progression, especially in Pancreas mets. However, 1 month later, the patient felt much better physical condition that better than past 3 years. It seems that from that time, the lung tumors have shrunk significantly so that the patient stopped coughing.
Therefore, this amazing result should be attributed to the combination of PD-1 and Cediranib? Would Cediranib alone can achieve such significant results?
If this is partly because of PD-1, it seems that PD-1 therapy may result in pseudoprogression?
What should this patient do next? She has stopped PD-1 therapy for about 3 months and now taking Cedirinib only. Should she continue using PD-1 therapy or just taking Cedirinib to see the result in next scans?
I attach the pictures that are the comparison of two latest lung CT scan results. the picture on the left is the scan done Nov 2015; and the picture on the right is the scan done Sep 2015. Please feel the incredible changes in her lung!!!
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