This week marks the beginning of a new chapter in Sherri’s treatment, the suspension of chemotherapy and the first trial of immunotherapy. Didn’t quite start as planned, but came to the same conclusion a day later.

We dropped off the girls with friends and headed to my sister’s place in MD on Sunday night for our planned visit to Hopkins. Thanks y’all for integrating us foreigners with your families on a few school mornings. Despite being out of your normal routine, you made us all feel comfortable and welcome! Then we inched our way into downtown Baltimore for a biopsy on Monday morning. To make a long story short, they couldn’t find any liver tumors big enough to see on ultrasound so a dozen doctors, nurses, pathologists, and ultrasound techs twiddled away the morning with us. Any day you can avoid having someone stick a needle in your liver is a good day! The tumors apparently have continued to shrink substantially, and they didn’t need the biopsy to qualify for the study.

What they did need was blood parameters in range, and they didn’t get those either. Two pancreatic enzymes, amylase and lipase, were too high to qualify for the trial. So we had to scurry out to find a place to redo those two tests late Monday afternoon. When they got the results on Tuesday, both were back in range but it was too late to schedule the procedure so we stayed over and did it on Wednesday.

The clinical trial procedure involves 6 vaccine injections, plus an IV infusion of the antibody ipilimumab (see Ipi Ki-Yay). Apparently the reason purple is the official accessory color for pancreatic cancer is that they find many different ways to make parts of you turn purple. The vaccine treatments were fairly successful at that, and they warned us that a rash is one of the more certain side-effects. Nothing comes for free in this game! So far, though, most of the effects feel like anytime you get a fever due to your immune system fighting back!

Speaking of games, fights , and purple reminds me that the Bryn Athyn College men’s hockey team is hosting a Shooting for Sherri event at their home rink tonight at 8pm to continue to raise cancer awareness and express their support. Of course, the BAC hockey players are great sportsmen and would only ever fight for a good cause. Thanks men and fans – Rock the Purple!

Breaking news: Sherri has been accepted into this immunotherapy trial at Johns Hopkins, in the arm that receives a vaccine/ drug combination instead of her current chemotherapy treatment. We’ll be starting the trial on Jan 28, Sherri’s birthday. Let’s hope it will be a poetic re-birth day! (More info below)

There is perhaps a turning point coming into focus, but it’s a little bit renegade. Last Monday, Jan 13, we visited the Johns Hopkins Kimmel Cancer Center in Baltimore to meet with the team in charge of a clinical trial underway there. This is one of the immunotherapy trials that we’ve been keeping an eye on, and the time seems to be right for considering it now. The trial combines a pancreatic tumor vaccine with an antibody called ipilimumab (“ipi”) in a new test for effectiveness compared to FOLFIRINOX (the current chemo regimen that Sherri is on).

According to the research disclosure, the concept behind the trial is to boost the immune system using the vaccine in combination with ipi. The vaccine uses genetically altered pancreatic cancer cells to make a factor called GM-CSF that helps attract a person’s own immune cells to the vaccine site where they can become activated to help recognize and attack cancer cells. Ipi is used to block CTLA-4, which is a molecule that can shut down immune response to infection or cancer cells. An antibody to CTLA-4 can stop it from turning off an immune response, and may be able to boost the immune system against the cancer. Both the vaccine and ipi have been used with some success, but not yet tried in combination for pancreatic cancer.

Here comes the tricky part. The trial is randomized, so once enrolled Sherri would be selected for either the vaccine/ipi treatment or for continuation with FOLFIRINOX. If selected for the vaccine/ipi arm, there are substantial new risks and side-effects from both the vaccine and ipi. The FOLFIRINOX regimen is currently controlling and shrinking the tumors, which makes it difficult to make the decision to move on to something else. However, continuation of this chemo treatment will inevitably reach a point of diminishing returns where a different treatment would be required anyway. One advantage of moving to a new treatment now is that her own immune system would be stimulated while it is still healthy and to fight a cancer that is more or less under control. Going forward with this treatment would not preclude a return to chemotherapy, and in fact in some cases has made chemo more effective. Also it appears from our inquiries with UPenn that going down this path still leaves open the possibility to qualify for their upcoming immunotherapy clinical trial using CAR T-cells. So several of our immediate concerns have been addressed.

Sherri did the initial screening for the vaccine/ipi trial when we were at Hopkins on Monday. Some of her blood counts were slightly lower than required, so with the concurrence of her oncology team here at FCCC we decided to skip the chemo treatment last Thursday. After a short reprieve this week we’ll be back to FCCC on Thursday for another blood test to see if everything is rebounding as it should. All other requirements for the trial have been met and we’ll be making a decision soon, so we’ll keep you posted.

Thanks again to the Bryn Athyn College athletics programs and fans for raising awareness and funds for the Pancreatic Cancer Action Network! And thanks to everyone for your continued support at every level; physical, emotional and spiritual. We may get behind in keeping in touch with you all, but please know that your thoughts and prayers, messages and visits are all making a huge difference.

This week Bryn Athyn College will be hosting a hoops double header with a purple twist:

The BAC Athletic department warmly invites you to help bring awareness to a cause that is near and dear to its heart this season- our Shooting for Sherri night this Thursday 1/9, beginning at 6:00 pm. The Lions will battle it out against Penn State Brandywine in hopes to bring the college community together for a cause. Proceeds from donations, ticket sales, and money raised through the silent auction will go to the Pancreatic Cancer Action Network. The event is designed to increase pancreatic cancer awareness and show our support and care for the entire Cooper family-Sherri, Dave, Zia and Anji. We hope to see you there and wearing purple!

Thanks, Bryn Athyn College athletes, coaches, administration, faculty, staff, students, and community for this action and tribute! See the Support page for more details, and follow Bryn Athyn College Athletics on Facebook (www.facebook.com/brynathynathletics).

Rock the Red!