The Devil You Know

As promised, we met with Sherri’s oncology team at Fox Chase, and it seemed pretty unanimous that she should start back on chemotherapy, so she’s been back on it. We appreciated getting some perspective from them on where we are compared to where we started. There is pretty definite growth of the tumors, but nowhere near where it started; this is a preemptive step to keep the re-growth under control. For anyone out there who likes to see quantitative data, here is what the progression looks like as documented in the CA19-9 tumor marker since first diagnosis.

Interpretation: The chemotherapy dramatically reduced the tumors, and immunotherapy kept things relatively stable with a much more tolerable set of symptoms to deal with. So Sherri is grateful for the reprieve over the past 6 months. Now we’ll see how the chemotherapy goes for the next round.

Her new treatment is similar to the original FOLFIRINOX, minus the oxaliplatin, which was the likely cause of some of the neurological symptoms such as cold sensitivity and numbing of the extremities. The new treatment is FOLFIRI, without the NOX. This is most of the concoction that worked well before, so we’ll be keeping an eye on how it does without the third component. The docs suggested keeping other promising chemotherapy options in our back pocket for later.

In the meantime, Sherri got a call last week from UPenn to interview her for possible participation in another, more aggressive immunotherapy. This is the RNA CAR T-cell treatment that we’ve been tracking – she’s been on the waiting list, and is now scheduled to meet with them in August to see if  she qualifies. It’s a Phase 1 trial, with only 10 patients able to participate, but it has great promise and we are excited to be part of it in any way possible. Check out this very informative presentation about “Activating the immune system in pancreatic cancer” from Dr Beatty at UPenn School of Medicine. Skip to slides 15-16 if you want a quick summary of the CAR T-cell process.

So there you have it. The devil you know vs. the devil you don’t. Choose your poison, and your metaphor. And keep your fingers crossed!