Today I had my monthly visit with Dr. Kipps and I have to say it went well. My White Blood Count (WBC) only went up about 5,000 to 73,000, which is the smallest increase I have had since January of this year. Also, my spleen and lymph nodes are staying about the same size. All of this points to a stable plateau which is good because it means we don't have to rush into any treatment immediately. We also discussed the clinical trial that I think I am going to enter sometime in August. End of Short Report.
If we had followed the same trend that we saw in the last couple of months I am afraid I would have been unable to participate in the clinical trial that I wanted to be in. I think Dr. Kipps was also concerned about what my numbers and exam were going to show because it would have put us in a situation where I would have had to start treatment in the next month. At my last visit Dr. Kipps gave me two papers on the clinical trials that were going to be open in the next couple of months. After reading them over (if you can call it that) and having several conversations with the Clinical Trials coordinator at UCSD I had pretty much made up my mind as to which one I wanted to participate in. At my visit today I discussed the two trials with Dr. Kipps and I think he agrees with my choice. They are seeing some positive results from Phase I of this trial, and I will be entering Phase II. They hope it will start sometime in August, which is great for me timing wise. One of the most important factors for me is that I didn't want to limit my options for future treatments. With some of the harsher treatments, there is a risk that you may become refractory to that or other treatments, which then limits your options.
The detail below outlines what the ABT-263 trial is supposed to test.
Bcl-2 Family Protein Antagonists (ABT-263)
Apoptosis, also known as programmed cell death, is a natural process by which damaged or unwanted cells, including those that are or could become cancerous, die and are cleared from the body. The Bcl-2 family proteins, which are expressed at high levels in many tumors, play a central role in regulating apoptosis and, consequently, in tumor formation, tumor growth and resistance to treatment. Researchers have been interested in the pro-survival members of the Bcl-2 family since their role in preventing apoptosis was established more than a decade ago. Pioneering structural biology work at Abbott showed how Bcl-2-like proteins interact with one another, thereby setting the stage for Abbott researchers to develop novel compounds that cause cancer cells to self-destruct.
ABT-263 restores programmed cell death by blocking the function of pro-survival Bcl-2 family proteins. Pre-clinical data have shown that Abbott's Bcl-2 family protein antagonists effectively kill certain cancer cell types. Additionally, Abbott Bcl-2 family antagonists were found to enhance the effects of chemotherapy and radiation in other types of cancer, such as non-small cell lung cancer. ABT-263 recently entered Phase I clinical trials for lymphomas, chronic lymphocytic leukemia (CLL) and solid tumors, including small cell lung cancer.
There are some risks associated with this treatment, but they are far less than the risks of a standard chemotherapy based protocol. I did ask him what were some of my other options if this didn't work, and he said not to worry he had a lot of options that he could use with me.
Today I also had my monthly IVIG, and so the day was pretty long, 11 ½ hours from door to door.
On another note, I had my second cataract surgery performed (one in May, one in June) and I am able to see with little correction. It turned out great. Also, Donna had surgery on a torn meniscus, and is now mending quite nicely. Never a dull moment for medical issues at the Evans house.
