Living and thriving as a cancer survivor

Anne’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, Anne developed a cough that lingered and intensified for months. Eventually, her doctor ordered a chest x-ray and treated her for pneumonia. Anne’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 Anne 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 Anne 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. Anne’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.

Anne’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 Anne on an “off-label” basis to treat her HER2-positive lung cancer. Working in close collaboration, Enhertu became the consensus recommendation for Anne’s next treatment regimen.

Anne 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.

Living her best life
Anne 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!

While her weekly calls with her Care Team are no longer necessary, they continue to monitor her disease with medical imaging and molecular testing. Anne 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.

Anne 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.

*name changed to protect privacy