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New Whitepaper Available! The Importance of Clinical Trials in Cancer Care

Case Study

Living and thriving as a cancer survivor

Published May 22nd, 2024

Becky’s boundless energy and zest for life envelops everyone around her. As a former personal fitness trainer, she maintained an active life with a particular passion for Pilates and gleefully running around with her grandchildren.

In early 2021, Becky developed a cough that lingered and intensified for months. Eventually, her doctor ordered a chest x-ray and treated her for pneumonia. Becky’s cough persisted, landing her in the ER where a CT scan revealed cancerous masses in her lungs and nearby lymph nodes. An MRI also showed cancerous lesions in the brain. In November 2021, she was diagnosed with Stage IV lung cancer.

As an expression of gratitude for the positive impact Becky had on their lives, the husband of one of her former personal training clients sponsored her cancer care management services from PHM to ensure she received the best possible care and outcome.

Although Becky was already receiving care from a medical group under her health plan, she needed guidance, support, and reassurance from PHM. Her PHM Personal Care Team immediately rallied around her confirming her diagnosis with our cancer experts, using molecular profiling to support the optimization of her treatment plan.

Molecular profiling can inform whether a tumor will respond to certain therapies by classifying it based on underlying molecular features and genetic alterations. This allows for more individualized (and frequently more effective) treatments. One of the findings from the molecular diagnostics ordered by PHM was that her cancer cells expressed a high level of a marker called PDL1. This finding meant that she was a good candidate for a new class of highly effective immune-based cancer treatments called immune checkpoint inhibitors. PHM worked with her treating providers to design a first-line treatment regimen consisting of pembrolizumab (an immune-checkpoint inhibitor) plus chemotherapy.

This treatment regimen was initially effective, but when her cancer became resistant, her PHM Personal Care Team was already ready with a recommendation based on the molecular ”signature” of her cancer. Becky’s cancer expressed a gene called HER2 (human epidermal growth factor receptor 2 gene), which is commonly found in certain breast cancers but rarely found in lung cancers. Fortunately, several drugs that treat HER2-expressing breast cancer have been approved by the FDA.

Becky’s treating oncologist recommended participation in a clinical trial studying an experimental new treatment, but her PHM team proposed they consider a drug called Enhertu. At that time, Enhertu was only approved for the treatment of HER-positive breast cancers, but PHM knew it could be prescribed to Becky on an “off-label” basis to treat her HER2-positive lung cancer. Working in close collaboration, Enhertu became the consensus recommendation for Becky’s next treatment regimen.

Becky has been taking Enhertu since October 2022. She has had a great response and her disease remains stable. Subsequently, Enhertu received FDA-approval for use in lung cancers that express the HER2 gene, further validating this line of therapy.

“PHM took me from shock, fear, and hopelessness to a sense of hope after just one session. PHM has helped every step of the way and now 2 years later I am fully living and loving my life. Please use my first and last name. I want to shout my praises for PHM from the metaphorical rooftops!”

Becky Thomas

Living her best life
Becky told PHM her main goal while undergoing cancer care was to maintain her quality of life, which was carefully considered. Today, she reports that mission has been achieved; she is back to doing many of the activities she enjoys, even teaching Pilates!

Her Clinician checks in regularly with her to ensure her disease is monitored with medical imaging and molecular testing. Becky has peace of mind knowing there are treatment options in place, informed by the molecular signature of her cancer, if and when another line of therapy is needed.

Becky says she is living her best life, and is a “cancer thriver, not just a survivor.” We are honored to be part of making that possible and can’t wait to see what this vibrant woman does next.

About the Authors

Andrea Doberstein, MS, PA-C

Clinical Director

Andrea is a board-certified Physician Assistant with broad experience in Hematology/Oncology. At Private Health, she is a Clinical Director where her focus is supporting clients with complex cancer diagnoses.

Gareth Morrison, PhD

Research Director

Dr. Morrison is Director of Research at Private Health Management. He has more than 15 years of experience in academic research, with the past eight years dedicated to advancing cancer research.