Skip to content

Medical status summary and suggested next steps β€” 16 Nov 2025

This concise report is for simulation/gameplay purposes only and does not constitute medical advice.

Snapshot

  • Tumor marker (Ξ²-HCG, Roche): Reached a nadir of 9 IU/L on 29 Oct 2025 after a dramatic decline from peak values (>200k IU/L in Jul 2025). Subsequently: 10 IU/L (5 Nov), 24 IU/L (14 Nov). This is a notable uptick; clinical significance requires confirmation on repeat testing with the same assay/lab.
  • Hematology: Post-chemotherapy cytopenias have recovered. Platelets: 22–45 x10^9/L (21 Oct) β†’ 149 (4 Nov) β†’ 163 (14 Nov). ANC: 1.0–1.3 (21 Oct) β†’ 2.17 (4 Nov) β†’ 2.37 (14 Nov). Hemoglobin improving but still mildly low: 9.0–9.7 g/dL (late Oct/early Nov) β†’ 10.3 g/dL (14 Nov). MCV 101 fL on 14 Nov (macrocytosis, likely therapy-related/recovery).
  • Inflammation: CRP was very high in Mar–Apr (74–160 mg/L), improved to near-normal by Aug (6.5 mg/L on 20 Aug). No very recent CRP values in the excerpt.
  • Imaging: PET scan scheduled for 17 Nov 2025 (tomorrow) to assess current disease status.

Quick links to interactive charts: - Ξ²-HCG trend: /health-data/charts/bhcg_trend.html - Comprehensive biomarkers: /health-data/charts/comprehensive_biomarkers.html

Treatment and course to date (abridged)

  • Initial presentation Mar 2025 with very high Ξ²-HCG (70,482 IU/L), CRP elevated, anemia; subsequent surge to 220,096 IU/L on 29 Apr.
  • Paclitaxel/Carboplatin cycles: 22 Apr (C1), 14 May (C2), 25 Jun (C3 + Pembrolizumab). Immunotherapy-only day on 4 Jun.
  • VIP regimen (salvage): VIP #1 (21–26 Jul), VIP #2 (11–16 Aug), VIP #3 (8–13 Sep), VIP #4 at 70% dose (6–11 Oct).
  • Supportive: Frequent hyperthermia/IV sessions, hospitalizations for infection (Aug), ongoing oncology follow-up.

Ξ²-HCG trajectory (selected): - 29 Apr: 220,096 β†’ 12 Jul–Aug: rapid fall (7,324 on 7 Aug) β†’ 139 on 28 Aug β†’ 82 on 5 Sep β†’ 26 on 26 Sep β†’ 20 on 3 Oct β†’ 12 on 20 Oct β†’ 9 on 29 Oct β†’ 10 on 5 Nov β†’ 24 on 14 Nov.

Interpretation (data-driven)

  • The VIP-based regimen achieved a robust biochemical response with near-normalization of Ξ²-HCG by late Oct, consistent with strong treatment effect.
  • The subsequent rise from 9 β†’ 24 IU/L over ~16 days is a meaningful relative increase (>150%). Single values can fluctuate; however, two consecutive rises (9 β†’ 10 β†’ 24) warrant confirmation and close monitoring for early biochemical progression.
  • Bone marrow recovery is evident (platelets and neutrophils normalized), which is favorable for proceeding with further diagnostics or therapy if needed. Macrocytosis and mild anemia are typical post-chemotherapy/recovery findings.

Suggested next steps

  1. Confirm marker kinetics
  2. Repeat Ξ²-HCG urgently (within 48–72 hours) using the same laboratory/assay. If rising again, recheck weekly to establish a clear slope and doubling time.

  3. Add CRP and a basic chemistry panel to correlate with systemic inflammation and organ function.

  4. Correlate with imaging

  5. Proceed with the PET scan on 17 Nov 2025. If positive or equivocal, consider targeted cross-sectional imaging for anatomical correlation, depending on PET findings.

  6. Multidisciplinary review

  7. Present at tumor board with: full Ξ²-HCG timeline, recent counts (showing recovery), and PET results. Discuss options based on response pattern:

    • If PET-negative/minimal uptake and Ξ²-HCG stabilizes on repeat testing: continue close surveillance with twice-weekly Ξ²-HCG for 2–3 weeks, then weekly.
    • If PET-localized residual disease and rising Ξ²-HCG confirmed: consider local control options (surgical resection if feasible) versus systemic escalation (e.g., additional VIP/salvage, high-dose chemotherapy with support) per protocol and histology.

  8. Supportive care and monitoring

  9. Maintain infection prophylaxis vigilance given recent neutropenia history; continue weekly FBC until counts are consistently stable, then space out.
  10. Manage anemia symptomatically; monitor MCV and B12/folate/iron if fatigue persists.

  11. Track performance status, weight, and treatment tolerability.

  12. Documentation and visualization

  13. Keep using the Ξ²-HCG and comprehensive biomarker charts to visualize short-interval changes after the upcoming tests and PET.

Data sources

  • Blood tests: data/processed/blood_tests.csv
  • Treatment timeline: data/processed/treatment_timeline.json