Friday, April 22, 2011

Ahoy Yervoy

It is official. I have enrolled in the Yervoy (or better known as ipi trial) trial at Memorial Sloan Kettering.

*I will give a full report of my latest NYC trip tomorrow...Too tired tonight!*

What is Yervoy? (Yeah, it does not sound like english to me either.) To briefly break it down for you...

Ipilumumab is an antibody that activates the body's immune system to fight melanoma. As someone said to me today, your immune system can really "stick it to melanoma." Hopefully that will be the case. Side effects can vary greatly, which makes sense if you think about it because the human immune system varies from person to person. No two people will respond the same way. "The most common side effects of ipilimumab occur in the gastrointestinal tract (such as diarrhea and inflammation of the colon) and the skin (such as rash and inflammation of the skin). Less frequently occurring side effects include hepatitis, inflammation of the pituitary gland (hypophysitis), eye inflammation (uveitis), and kidney problems (nephritis). Side effects occur in up to 84% of patients but are generally mild and treatable." I will be in close, close contact with The Wizarad and his staff. If there is anything that causes them to raise their eyebrows, they will evaluate me and see how to handle it.

Ipilimumab was FDA approved while I was in the hospital a few weeks ago. The approval of this drug is major. (As surgeon had tears in her eyes type of major!) According to Richard Pazdur, MD, director of the Office of Oncology Drug Products in the FDA's Center for Drug Evaluation and Research, prior to Ipilimumab, there were little treatment options available for patients with advanced melanoma. There were no options that prolonged a patient's life. *Now do you see why the FDA approval of Ipilimumab is so major?!

Here is what will happen:

On May 6th I will head back to NYC for another CT Scan & brain MRI. If all is well, I will return to NYC on May 20th for my first treatment. I will meet with The Wizard at 9:15 to have labs completed that will assure I am healthy enough to go forward. I will give both a blood & urine sample. They have to make sure all is OK---and that there are no buns in the oven--before sending me to the "Chemo Suite." 

Yes...they will be giving me a preggo test at every appointment. Nothing like a good ol' safe sex talk in front of my mother...

After The Wizard clears me, I will head over to the next floor---the "Chemo Suite." I will be hooked up for 90 minutes. Once I finish my cocktail-by-iv, I will be observed for an hour to make sure nothing dramatic happens. Then I get to go home. This will happen once every 3 weeks for 4 infusions. I will be scanned every 12 weeks to see what is happening inside of me!  After the 4th infusion, I will go on a 3 month schedule for 3 years.

Good thing I like New York City, right?

Here is the tricky part about this trial: there is a 50% chance I will receive the drug. There is a 50% chance I will receive a placebo. I will never know for sure which I have received. The doctors will never know for sure which I have received. Sure, we can guess by the side effects, but no one will ever directly tell us.

Why am I doing this even though there is a chance I will receive a placebo? For starters, there is a 50% chance I could receive the drug...the drug that is being proven to help advanced melanoma patients. Even if I do not receive the drug, I will be closely observed for the next 3 years. God forbid the cancer advances, we will know right away.

The Wizard spelled it out for me today: "You have a hard decision to make. You are stuck between a disease that can lead to mortality or you can try a drug that could lead to mortality. Unfortunately we know that the recurrence rate of advanced melanoma is high...If it comes back, and you have done this trial, you will know that you have done everything you could possibly do."

Isn't that why I did the surgery? (Which I totally do not regret.)

I am a fighter. I think that is the one thing in my life I know I am good at. So, I am going to fight. Yes, I am dedicating 3 years of my life to this trial; however, 3 years is nothing in the grand scheme of things.

Once I get through the 4 infusions, I will be able to return to my normal life. (I am looking forward to that!) Thanks to my amazing doctors, friends, and research, I know that choosing to do this trial is the absolute best thing for me.

You gotta do what you gotta do sometimes, right?

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