The good news is that we have been enjoying a false sense of normality for the past few weeks as Bobbie has evidently been feeling the best that she has since probably May of 2008. So, that has been nice.
So, the nitty gritty on the medical front is this. Bobbie's medical and surgical oncologists agreed that she should attempt a fairly aggressive effort toward attacking the cancer at this stage. As a result, we were referred to a doctor at the Blumenthal Cancer Center in Charlotte, NC. He was very kind, patient, straight forward and informative. We met with him a few weeks ago and had a lengthy appointment (3+ hours) discussing potential treatments and the logic and realism behind entertaining each of them. The result is that she had 4 treatments to entertain:
2 FDA approved:
2 clinical trials
- Temodar + trial drug
- Ipilumab (CTLA 4)
Of the two FDA approved options, the Temodar was mentioned in my last update along with the IL-2. The new oncologist described that he would not utilize IL-2 until Bobbie has been brain healthy for 6-9 months and has intestines not showing any sign of large tumors working as wall structure. The reasons are that there is an estimated 20 pound fluid weight gain and loss during the 5 day treatment and there is a risk that significant amounts of fluid could leak into the brain and basically squeeze it against the skull and risk death by stroke. Temodar remains an immediate option with about a 10-12% response rate.
Of the two clinical trials, Bobbie has been excluded from the Temodar plus trial due to her previous clinical trial with the brain tumor and the Giladel wafers, so that is not an option. She was explicitly not excluded from the Ipilumab trial (which is the one that all 3 doctors seem to be the most hopeful about), but all that really means is that she qualifies to apply for inclusion in the study.
And now for the tricky math - the Temodar treatment would automatically exclude her from any clinical trials, whereas the clinical trials do not preclude her from utilizing the FDA treatments. So, the current plan is to shoot for the Ipilumab study and hope that it does the deed. If that falls through, or even if it doesn't work, the Temodar option remains open as a fallback plan.
So, not a lot to report really other than we are moving forward. Her next steps are:
- a follow-up MRI and appointment next Wednesday, March 11, with her neurologist at UNC
- assuming nothing other than good news there, an MRI, PET scan and some blood work with the doctor in Charlotte in hopes of qualifying for the Ipilumab study - applications for that open within the next couple of weeks
It has been nice enjoying the last couple of weeks and hope that there is much more of that to come, regardless of what path lies ahead of us. Just wanted to at least get something out to let you all know what we're up to. If not before, I'll fire off another update once we know what's in store.
Thank you all for your inquiries in the absence of my updates.
No comments:
Post a Comment