How precision medicine and a life-saving clinical trial turned a grim prognosis into a cancer-free diagnosis

When Peter*, an adventurous 60-year-old, was diagnosed with stage 2 esophageal cancer, he underwent standard treatment with chemotherapy, radiation, and surgery, and hoped that cancer was behind him. Unfortunately, his cancer recurred just five months later. Over the next three years, as his cancer spread to his liver and lungs, he faced a relentless journey of multiple recurrences, debilitating treatments, and limited options. Eventually, Peter’s oncologist told him that he had run out of treatment options and gave him just three months to live. Yet, in the face of a grim prognosis, Peter’s refusal to give up led him to Private Health Management (PHM).

PHM’s Personal Care Team of clinicians and researchers reviewed existing molecular testing of his tumor, which examines the DNA, RNA, and proteins in the cancer cells to identify specific mutations, evaluate gene expression, and analyze other molecular alterations involved in tumor growth. By uncovering these details, molecular profiling helps doctors tailor treatment to target the specific abnormalities in a patient’s cancer.

Peter’s Personal Care Team determined that additional testing could provide a more comprehensive picture of the specific factors driving the growth of his tumor and arranged for further molecular profiling. In Peter’s case, molecular profiling results identified two potential treatment strategies: 1) targeting an alteration in a gene called Notch-1, and 2) using immunotherapy to try to get his immune system to fight the cancer directly. This was a surprise, because Notch-1 mutations are not commonly associated with this type of esophageal cancer.

Armed with this information, the Care Team quickly arranged for him to meet with several leading experts, and they had differing opinions on the best way to proceed. One expert recommended that he try immunotherapy, while the other favored enrolling him in a clinical trial of a drug that specifically targets the Notch-1 pathway. Peter was now faced with the difficult task of deciding which treatment option was best for him.

To help Peter make his choice, PHM conducted a review of the scientific literature and provided him with an in-depth analysis of the treatment options, explained the rationale for the clinical trial drug vs immunotherapy, and reviewed the preliminary data on both approaches with him. In addition, PHM educated Peter about the benefits and risks of enrolling in a clinical trial and gave him an overview of what to expect as a participant. Peter also understood that he could try the clinical trial for a few months and switch to immunotherapy if the drug was not helping.

Ultimately, Peter felt confident in his choice to enroll in the clinical trial. PHM worked with the clinical trial coordinator to confirm that Peter was eligible to enroll in the trial and managed his enrollment, including trial screening and consent. Remarkably, after just two months of receiving the targeted treatment, Peter’s disease started disappearing, and within nine months he showed a complete response. He was able to discontinue the treatment and remained cancer-free for over eight years.

Peter’s story highlights the importance of understanding the biological drivers of cancer growth through precision medicine and navigating the complex clinical trial landscape to provide patients with access to the latest treatment advances.

To learn more about clinical trials, download our information guide.

*Name changed to protect privacy.