Empowering Patients: A Closer Look at the Battle Against Cancer at Memorial Sloan Kettering Cancer Center
In December 2015, a family faced a life-altering challenge when their mother was diagnosed with stage III pancreatic cancer. A detailed CT scan revealed a non-operable tumor, while a subsequent biopsy confirmed the diagnosis of “classical” adenocarcinoma located in the midsection of the pancreas. The journey from diagnosis to treatment options highlighted the importance of genetic testing and innovative therapies.
Navigating Genetic Testing for Treatment Insights
As part of the treatment process, genetic testing was performed on both the tumor tissue and the patient’s germ line. The results revealed a CHEK2 mutation, typically associated with breast, prostate, and colon cancers, but not directly linked to pancreatic cancer. Additionally, mutations in KRAS and CTNNB1 were identified.
The team also explored the potential for microsatellite instability (MSI) which could have opened avenues for immunotherapy. Unfortunately, the tests indicated that the tumor was MSI negative, limiting the available treatment options based on genetic findings.
Chemotherapy: The First Line of Defense
Under the care of Dr. Eileen O’Reilly at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, the family opted for the standard chemotherapy regimen known as FOLFIRINOX. While the chemotherapy led to significant improvements in the patient’s CA 19-9 levels—dropping from over 250 to below 50—imaging studies did not reveal a reduction in tumor size, possibly obscured by scar tissue.
Exploring Radiation Therapy Options
As the twelfth treatment approached, the family considered their next steps. They weighed participation in a clinical trial at Johns Hopkins that combined high-dose radiation with immunotherapy against stereotactic body radiation therapy (SBRT), a method delivering targeted radiation either over five or twenty-five days.
Ultimately, they chose SBRT, guided by the expertise of Dr. Christopher Crane, a radiation oncologist with a successful track record in treating non-operable pancreatic tumors. In preparation for her treatment, the patient underwent a biopsy, placement of fiducial markers, and the creation of a body mold to ensure precise targeting.
By early June, she began her 25-day SBRT course, supplemented with a low dose of capecitabine. Early indications showed she continued to feel well, and her spirits remained high.
The Quest for Personalized Treatment Solutions
In addition to SBRT, the medical team extracted additional tissue during the May biopsy to create an organoid. This innovative approach, led by Dr. David Tuveson at Cold Spring Harbor Laboratory, aims to facilitate high-frequency drug testing tailored to her specific cancer profile. The family eagerly awaits results to determine if the organoid successfully developed.
The narrative of this family’s journey reflects not only the challenges of battling pancreatic cancer but also the promise of developing personalized treatments through cutting-edge medical research.
Conclusion
The struggles faced by this family are a poignant reminder of the relentless fight against cancer. Despite the outcome, their journey contributed valuable insights into treatment options and the importance of exploring every avenue available.
For further information on pancreatic cancer treatments, you can explore related articles on tumor genetics and stereotactic body radiation therapy. Understanding these advancements can help patients and families navigate their own journeys with more clarity and hope.
