27 July 2012

Testing, Testing

I found out this morning that I *will* be receiving the fancy new drug, TDM1 or, as it's recently been named in preparation for sales, Trastuzumab Emtansine, when I begin my clinical trial infusions on Thursday next week. The drug is almost ready for full FDA approval, but does not yet have it, and so my oncologist is really, really excited that I get to take it in the trial (there was a 2/3 chance in the favor of TDM1 in this randomized study. My other option would've been a Taxol-like chemo [read: pretty traditional, with hair loss and neuropathy and nausea.]). 

This drug is a new combo-drug, where Herceptin (the trastuzumab part) and a really evil chemotherapy agent (the emtansine part) are somehow connected, and infused together as one thing. The Herceptin brings the chemo to the Her2-positive metastasized cancer, and something happens at the site of the cancer and the chemo agent is released, right where it belongs.

There are supposed to be very few side effects, essentially no more than with Herceptin itself, and so it's relatively easily tolerated, as long as your heart keeps ticking along.
Yesterday I got the results from all my scans of a fortnight previous, which were as follows: 
  • MUGA (heart function): normal. 
  • CT of neck to pelvis: soft tissues normal with the exception of the lungs, which show evidence of healed trauma. Some evidence of sclerotic changes to bones, but not many. This could be arthritis, but I'm not feeling any pain in any of the places. 
  • MRI of Brain: Stable. 
  • EKG: normal. 
  • Usual blood counts: Normal. Tumor markers high. 
At this point, Dr Specht was wondering if I had enough evidence of active cancer in my body to qualify for the study, but yes, I did still qualify. And besides, my bone scan was slightly less good than my other scans, but things that had shown up before on my ribs weren't there anymore, and the other things that showed up as different in the bone scan couldn't necessarily be verified as cancer activity. 

My new schedule starts next Thursday, and is a 3-week schedule, just like the Herceptin alone was. I've already figured out how to adjust my treatment dates to accommodate travel this fall, which means that for the next few months my "every three weeks" is going to be slightly off--21 days, then 21, then 19, then 18, then 24, or something like that, so that I'll be able to fit 3 weeks in South America in to my schedule. I do hope the promise of limited side effects holds true, because for all this to work, I will be infused on my 40th birthday.

We did have a couple days of summer here . . . it's not too late . . . we may still get a couple more . . .