Treatment of advanced metastatic cancers may benefit from the information provided by genomic testing. In "Connie"’s case, tumor subtyping opened up a new line of therapy and new hope.
In this molecular profile, our fictional patient, Connie, is a 61 year-old woman who noticed that she was getting progressively weak over a period of a few months. She had noticed some irregular vaginal bleeding but thought that this was just part of the “change.” Upon evaluation by her physician, she was found to be profoundly anemic. Further evaluation showed a large endometrial cancer which had metastasized. She initially responded to first-line therapy with carboplatin plus paclitaxel. Several months after initial treatment, however, her tumor has progressed.
Her physician subtyped her tumor using further molecular testing, revealing a PIK3CA mutation and a PTEN deletion.
Rather than agreeing to further chemotherapy which typically has a lesser chance of working as a second line regimen, Connie was alerted to an ongoing clinical trial for which she might be eligible on the basis of the results of the test.
Note: This fictional, composite story, which includes data from actual representative patient cases, conveys how information from comprehensive genomic testing may impact treatment for management and care of people suffering from cancer.
Metastatic endometrial cancer
Carboplatin plus paclitaxel
A Phase II clinical trial of an AKT inhibitor in patients with recurrent or persistent endometrial cancer classified by PIK3CA mutation was enrolling patients at a center not far from Connie’s home. She was referred for evaluation for that study.