Saturday, June 18, 2011

Here We Go Again

Regime change coming on Monday. The consensus recommendation of Rifkin and his colleagues at the last ASCO meeting (American Society of Clinical Oncology) is to put me on a regime of vorinostat and velcade along with my every other day prednisone. Vorinostat has been around for awhile but hasn't been used extensively in treating myeloma. The results from a few trials, however, are quite promising. It is an HDAC inhibitor which appears to enhance the efficacy of velcade, even in patients who have become resistant to velcade. Histone deacetylases are a class of enzymes that interfere with certain proteins. When given with velcade it has been shown to increase cancer cell death. The clinical trials in which it has been tested have generally included patients who have had extensive treatment, like me. So, this starts on Monday. I take vorinostat orally for 2 weeks and during that 2 weeks I go to the clinic twice a week for velcade shot. Then a week off and start the 2nd cycle. This will continue as long as I can tolerate the drugs and we are making some progress in reducing the myeloma. Rifkin decided to go on this course because it appears the final regulatory approval for open access to carfilzomib will take some time and I don't think he was comfortable delaying treatment for me. I agree.

I'm schedule for another bone marrow biopsy in a week to determine state of my disease. I doubt much has changed because I have difficulty holding my red cells and platelets. I attribute it to the bone marrow being packed with myeloma. I've had 2 transfusions in the last 2 1/2 weeks, the latest being yesterday. But that hasn't stopped me from riding my bike daily. I now log between 15 and 20 miles and have my sights on 30 miles (did 22 miles this morning--day after the transfusion. Blood doping works!).

I feel like I've finally recovered from the cytoxin onslaught and my days feel busy, even though they are quite slow in comparison to all of your busy lives. But it's nice to have the energy to get out and ride the bike or go out to lunch or even to an occasional baseball game. I've wanted to go out to NYC to visit Catherine but Rifkin still has me on the no fly list, so Catherine will be coming home in a few weeks for a short respite in the mountains with the family.

Best to all and Happy Fathers Day to all you Dads.


tim's wife said...

Tim's doc is a huge clinical trial guy. I've met several of his patients who were very heavily pre-treated, and resistant to all the typical MM drugs, and they responded well to Vorinostat. Hope it works well for you too. Your bike riding is amazing. I played in a charity softball game and was sore for 3 days!!! Sending warm thoughts from Jersey, where the first mosquitos(our state bird) just hatched.

dan patterson said...

Tim's wife,
A well kept secret: I moved to Colorado more than 32years ago after few summers in Minnesota. As I like to say, we don't have bugs here. Thanks for the info on vorinostat. I haven't heard of anyone with MM getting it.

Steven L. Ritter said...

Great Job on the Bike Riding... 22 miles is great!!

Someday maybe we can pick a time and do a ride... I would be willing to drive there to do that with the proper lead time!

Good luck on the MM drug!