Ms. Hang was diagnosed with bile duct cancer in 2021 and underwent surgery to remove the tumor. The disease recurred three years later, necessitating various treatment approaches.
This March, she arrived at Tam Anh General Hospital in TP HCM with continuous high fever, a dry cough, exhaustion, and body aches, requiring oxygen support. Examinations revealed multifocal liver lesions, including a 17x15 cm tumor, alongside widespread damage in both lungs.
Following a multidisciplinary consultation, doctors determined that Ms. Hang was resistant to all standard chemotherapy regimens. Doctor Do Hoang Kha from the Department of Internal Oncology, Oncology Center, opted to identify gene mutations using ctDNA liquid biopsy technology. This method involves drawing blood to detect circulating tumor DNA fragments, avoiding the risks associated with needle biopsies into the liver tumor.
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Doctor Kha examines Ms. Hang. *Photo: Tam Anh General Hospital*
Gene sequencing results identified three concurrent mutations in Ms. Hang: R273H on the TP53 gene, R1450 on the APC gene, and G12C on the KRAS gene. The KRAS gene typically controls and prevents excessive cell growth. However, when the KRAS gene mutates at the G12C segment, it sends continuous division signals to cells, leading to abnormal proliferation and cancer formation.
Doctor Kha stated that targeted drugs are now available to specifically block the KRAS G12C mutation, a significant advancement as no specific treatment existed previously. Ms. Hang was prescribed daily targeted therapy. This medication works by specifically binding to the KRAS G12C protein, thereby blocking the signals that drive cancer cell division and growth.
After one month, Ms. Hang experienced reduced cancer symptoms but developed side effects, including elevated liver enzymes and pneumonia. The medical team administered anti-inflammatory drugs and supportive intravenous fluids for 15 days, stabilizing her health indicators. She continued her daily targeted cancer treatment.
After 4 months of consistent treatment, she was able to breathe independently, her abdominal distension improved, her appetite increased, and she could perform basic daily activities.
The CT scan results from her most recent follow-up showed reduced lung lesions and an 80% decrease in liver tumor size, now measuring 3,5 cm.
Doctor Kha explained that cancer-causing gene mutations can arise from environmental factors like chemicals, UV radiation, and bacteria, or from random, uncorrected errors during cell DNA replication. Early-stage gene mutation-driven cancers are often treated with surgery and chemotherapy. In late stages, targeted drugs can be an effective treatment option.
Doctors advise that patients with late-stage cancer resistant to standard chemotherapy should not abandon hope prematurely. Instead, gene mutation testing can provide opportunities for personalized treatment, potentially extending and improving their quality of life.
Khai Minh
*The patient's name has been changed.
