Renal Cell Live!

Saturday, February 21, 2009

Finnigan Begin Again

I've gone the rounds with my laptop, reinstalling software, and with my ISP, re-establishing my connection after they did some "upgrades" that left a lot of people offline. I think I'm actually back on a reliable basis now; all I have to do is sift through all the messages that built up in my Inbox while I was unable to connect, whoopee ...

Wednesday we went to Cleveland Clinic for scans. My liver tumors continue to show signs of necrosis, and that's good. The lung tumors have been increasing in size, very slowly, since June. However Wednesday's scans showed that the lung tumors had grown more aggressively in the last 3 months. I've been on Nexavar for over 3 years and, with these results, I'm very very close to an overall 20% growth total. That's a good indication that it's no longer working. We might have tried to increase the dose, of course, but I do develop the side effects so quickly that I doubt it would do much good. So, I'm now off Nexavar and we're evaluating several other options.

I've been expecting this to happen. We are dealing with first round results on new drugs, and nobody has good predictors on how these work or how long they actually prolong life. I'm pleased that the Nexavar worked for as long as it did (over three years!), and that I was able to get good sustainable results on a very low dose with few side effects. I'm also quite lucky in that the active tumors in the lung are still quite small and that I have a very low percentage of active disease compared with other people. A 20% growth indication in this case is actually a very small amount of growth.

Compared with several years ago I feel almost overwhelmed with choices - since that time lots of active research has been going on, and I actually have one FDA-approved drug, two clinical trials, and a second drug currently going through the FDA approval process for kidney cancer treatment to pick from.

At this point I'm leaning toward one of the clinical trials. It's a new type of targeted therapy that uses a protein on the tumor surface as a marker to identify the diseased tissue so that the body's immune system can work more effectively against it. I don't know what the rules are about potential disclosure so I won't mention any specifics here, for now. Hopefully I can say something about it as time goes on, if I am able to qualify for it.

The second clinical trial is for an oral version of the FDA-approved drug Torisel; the oral application is under consideration for FDA approval also. I'm still looking for information on that one.

The FDA-approved drug Torisel is an option, as is Avastin, currently under approval process for advanced RCC.

So, we have a lot of thinking to do about best options. I'll be able to continue with Dr. G at the Cleveland Clinic no matter what we choose, and that's the best news of all as far as I'm concerned!

It seems quite strange to be back in this position again after 3 years, making decisions that affect my overall survival. "Life and death" sounds so melodramatic but I guess it's appropriate.