Dr. K is recommending that Laura participate in a nation-wide clinical trial studying the effects of a new combination of PARP inhibitors, which prevent DNA repair, along with a drug called Cisplatin (a.k.a. Platinum). Statistics show that not having adjuvant chemotherapy, treatment of cancer post surgery, statistically have worse cure rates than patients who have adjuvant therapy.
There is a possibility that microscopic remnants of the cancer may still be in Laura's body since she did not have a complete response to her neo-adjuvant chemotherapy. In the adjuvant setting there is no way to know the effectiveness of a treatment except by looking at studies, which produce statistics and make an interpretation to generalize a cure rate from any therapies that have been administered. This is because there is nothing that can be measured any longer since the primary tumor has been removed. You are either cancer free or the cancer comes back. If it comes back it has generally metastasized (spread to another organ), which is not good at all, and treatment for metastatic cancer is a whole other ball of wax.
The clinical trial involves two control groups. One where patients receive platinum and the other is the newer combination of Platinum plus a PARP inhibitor. Platinum on its own has been shown to be clinically effective on patients with triple negative breast cancer who did not have a response to traditional drugs used to combat the disease. Although PARP inhibitors have shown promise, the combined effects of the two drugs are not known, and we won't know until after the study is completed and results are published, possibly years from now, what the statistical significance will be.
The effects of Platinum would be much like the AC chemotherapy Laura had earlier this year, only stronger. Here are the primary effects and differences of Platinum as described by Dr. K compared to Adriamycin/Cytoxan, the drugs Laura previously received:
We will find out more about the trial next week but we know the clinical trial doctors will set the stage for when Laura will do her radiation "time" and how the treatments will be delivered. Laura will still be under Dr. K's care throughout the clinical trial and beyond. The clinical trial doctors may be harder to reach and it is comforting to know that Dr. K is only a phone call away for any questions that come up.
Dr. K had an anecdotal story that was reassuring about the way she operates. There was a study some a years ago with Herceptin, which has now been shown to be a very effective drug for hormone positive cancer. There were 3 control groups for this study, two of which used Herceptin with a combination of some other drug and one group which did not receive Herceptin. A few years into this study it became clear that Herceptin was increasing the cure rate for hormone positive breast cancer. Dr K said she would never put any of her patients in the first study once these facts came to light, knowing that they would have a 1/3 chance of not getting a drug which shows evidence of helping her patients. I'm glad Dr. K thinks like this and we trust her experience and guidance.
Laura is tired from this long journey that will likely become a bit longer. Even after all of the immediate treatments to overcome her cancer and preventative measures taken by modern medicine Laura will continue to live with the shadow of triple negative cancer for the next decade wondering if she is cured or if the cancer will resurface. Laura remains strong and ready to take this next step and knows we are all behind her.
There is a possibility that microscopic remnants of the cancer may still be in Laura's body since she did not have a complete response to her neo-adjuvant chemotherapy. In the adjuvant setting there is no way to know the effectiveness of a treatment except by looking at studies, which produce statistics and make an interpretation to generalize a cure rate from any therapies that have been administered. This is because there is nothing that can be measured any longer since the primary tumor has been removed. You are either cancer free or the cancer comes back. If it comes back it has generally metastasized (spread to another organ), which is not good at all, and treatment for metastatic cancer is a whole other ball of wax.
The clinical trial involves two control groups. One where patients receive platinum and the other is the newer combination of Platinum plus a PARP inhibitor. Platinum on its own has been shown to be clinically effective on patients with triple negative breast cancer who did not have a response to traditional drugs used to combat the disease. Although PARP inhibitors have shown promise, the combined effects of the two drugs are not known, and we won't know until after the study is completed and results are published, possibly years from now, what the statistical significance will be.
The effects of Platinum would be much like the AC chemotherapy Laura had earlier this year, only stronger. Here are the primary effects and differences of Platinum as described by Dr. K compared to Adriamycin/Cytoxan, the drugs Laura previously received:
- Nausea
- Fatigue
- Kidney risk - a known issue which can be mitigated with proper IV hydration during administration
- Neuropathy - a tingling sensation felt in the limbs
- Ear ringing
- Loss of hair
- Vision problems
- Dietary constraints
- Bowel issues
We will find out more about the trial next week but we know the clinical trial doctors will set the stage for when Laura will do her radiation "time" and how the treatments will be delivered. Laura will still be under Dr. K's care throughout the clinical trial and beyond. The clinical trial doctors may be harder to reach and it is comforting to know that Dr. K is only a phone call away for any questions that come up.
Dr. K had an anecdotal story that was reassuring about the way she operates. There was a study some a years ago with Herceptin, which has now been shown to be a very effective drug for hormone positive cancer. There were 3 control groups for this study, two of which used Herceptin with a combination of some other drug and one group which did not receive Herceptin. A few years into this study it became clear that Herceptin was increasing the cure rate for hormone positive breast cancer. Dr K said she would never put any of her patients in the first study once these facts came to light, knowing that they would have a 1/3 chance of not getting a drug which shows evidence of helping her patients. I'm glad Dr. K thinks like this and we trust her experience and guidance.
Laura is tired from this long journey that will likely become a bit longer. Even after all of the immediate treatments to overcome her cancer and preventative measures taken by modern medicine Laura will continue to live with the shadow of triple negative cancer for the next decade wondering if she is cured or if the cancer will resurface. Laura remains strong and ready to take this next step and knows we are all behind her.
4 comments:
Thank you for the update Joshua. I admire you so much as a couple. These hard times are truly what marriage is all about. Both of you are inspiring.
PS - I'm glad to hear that Laura has a Doc that you respect and trust.
Hard times indeed.
Hang tough! There is a powerhouse of support behind you even though there seems to be precious little many of us can do - we are cheering you on!!
Thanks for the update. I'm glad to hear that there is a new plan in place but I'm sure it's tough to even think of climbing this next mountain. If anyone can do it though, Laura can! Lots of hugs, love, and thoughts headed your way. Am
Laura B: I SO appreciate your pats on the back to us both. It means a lot.
Nina: Yes - as you know. Tough times. But I do feel the far and wide support. Have your magnet on my fridge!
Amber: No doubt. Not looking forward to more chemo. But if it helps the situation, it's what must happen in my eyes. Gotta pull up my bootstraps (sound familiar?)!
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