A 57-year-old man with advanced lung cancer was admitted to Hadassah University Medical Center in Jerusalem, unconscious from dangerously low blood sugar (hypoglycemia). This was a rare complication of his cancer, in which the tumor secretes a protein that diverts sugar into the muscle, depriving the brain and other organs of glucose. This condition is usually seen in patients with very large tumors, and not only in the lungs. It can cause confusion, blurred vision, change in behavior, seizures and even death.
The doctors tried to raise his blood-sugar levels with conventional treatments but nothing helped. They feared for the patient’s life and decided to try something radical.
A breast cancer drug as a lifesaver
The doctors realized that the protein secreted by the tumor activates a molecular pathway that is also involved in cell growth in breast cancer. They decided to use a drug called Alpelisib, which is intended for the treatment of breast cancer. Alpelisib works by inhibiting this pathway, and thus prevents the excessive absorption of sugar in the muscle.
The drug was not covered by national health insurance and the patient’s family could not afford it. The doctors applied to the pharmaceutical company for compassionate treatment, but they were initially rejected due to the lack of prior knowledge in the medical literature. However, they managed to obtain a dosage of the drug through a national nonprofit organization called Haverim Le’Refuah (Friends for Health).
A scientific breakthrough
Within a few hours of treatment, the patient’s blood sugar levels increased dramatically. He regained consciousness and stopped suffering from hypoglycemia. The doctors were amazed by the results and realized that they had accomplished something extraordinary.
They collaborated with researchers from the Technion in Haifa to study the mechanism of action of Alpelisib in this case. They found that the drug effectively blocked the signaling pathway activated by the protein secreted by the tumor. They also measured the levels of this protein in the patient’s blood and found that they decreased significantly after treatment.
The doctors and researchers published their findings in the prestigious New England Journal of Medicine. They described their work as a scientific breakthrough that could provide a relatively simple solution to a challenging problem. They also reported that the pharmaceutical company agreed to fund the compassionate treatment for the patient for the rest of his life.
A hope for other patients
The doctors and researchers hope that their discovery will help other patients who suffer from severe hypoglycemia due to cancer. They believe that Alpelisib could be used to treat other types of tumors that secrete similar proteins, such as mesenchymal tumors. They also suggest that screening for these proteins could help identify patients who are at risk of developing hypoglycemia and offer them preventive treatment.
The doctors and researchers emphasize that their work is an example of how thinking out of the box and fighting for the patient can lead to innovative solutions. They also thank Haverim Le’Refuah for their support and cooperation.
