Feeds:
Posts
Comments

Archive for the ‘Xgeva’ Category

It’s been five months since I have made any regular visits to Las Vegas, and oddly enough, I’ve kinda missed it. But I’m gearing up for a new clinical trial and getting back on the road to my cancer treatment home away from home.

It’s just not easy to explain briefly how my health has been, but I’ll try. Last August I started my fourth treatment, third clinical trial, with Dr V. ┬áIt combined Taxotere (a standard chemotherapy) with Lenalidomide. The chemo lasted until December (they actually pulled the Lenalidomide after a couple of months when they found no benefit in early trial data).

So starting mid-December, I was off chemo and had no new clinical trials ready to go. We decided to start with Zytiga (abiraterone acetate), a new drug that had been approved by the FDA in April 2011. Since there was no study protocol, I began seeing a new oncologist in Salt Lake who could monitor lab work and give me monthly injections of Xgeva (denosumab), a bone-repair treatment that was FDA-approved in November 2010.

Somewhat surprisingly, I had good results for four months on Zytiga. It was surprising because my first clinical trial (Tokai’s TOK-001) was a drug that is quite similar to Zytiga. It seemed likely that my cancer might have already learned from that one how to get around this particular drug, which inhibits the CYP17 enzyme that is “required for androgen biosynthesis” (try reading the official literature on this drug for some real fun). Essentially it blocks anything, prostate cancer cells included, that tries to build androgen hormones. I like to think of it as an intense hormone blocker that has turned me into a soft blob of a human being. Something between the Michelin man and Mr. Bill. And then add on white curly hair from my chemo-perm. I don’t look like myself, lately.

The thing is, Zytiga worked for me, probably because I had been on a fairly low dose of the Tokai drug. In December, my last CT & bone scans showed that I had somewhat extensive bone involvement with my cancer, in spite of the chemo; my PSA was in the 300 range. Since then we’ve only really checked PSA levels, and they dropped as low as 97 before rising a little (112) and then jumping up higher (186). So, it looks like there are cancer cells that have found a new way to survive.

For whatever reason, I’ve had to deal with extensive pain since the beginning of the year. Honestly, I don’t know what’s intensifying the pain. I assume it’s tumor activity in bones, but with my PSA dropping while the pain increases, that doesn’t seem to tell the whole story. It could be that Zytiga is part of the problem, since known side effects include joint swelling and pain, and muscle discomfort. The pain could be related to Xgeva which, like Zometa, can induce muscle pain and flu-like symptoms. Of course, no drug company wants to take responsibility for my pain, and with multiple things going on, there’s rarely a clear answer.

Happily, we’ve got a new clinical trial now that my PSA is rising. Bayer has partnered with a Norwegian company, Algeta, that developed a treatment called Alpharadin. It uses a form of radium-223 to deliver low-intensity radiation directly to cancer cells. It’s a smart idea that has improved on similar drugs like Samarium-153, which has been used since 1998 for pain management of bone metastases. Alpharadin is on track for FDA approval, and the best thing is that Bayer has opened up their phase III trial for compassionate use. This means that if you qualify, they’ll let you in on the trial so you don’t have to wait for the FDA to grant their magic stamp of approval.

So, I’ve got the paperwork done and it’s looking like I can start within a few weeks. I had a quick visit at the end of April with the doctor, and yesterday I saw the clinic’s radiation oncologist for a review of my treatment history to get everything OK’d. Now we just have to wait for the radium to be delivered from some secret location in Norway

So, Las Vegas, I’m coming back. Be good to me, OK?

Advertisements

Read Full Post »