If there was any question whether the past trial I was on was working or not the CT scan I had last Friday definitively answered that with a profound No. Unfortunately the cancer has had an opportunity to grow and spread. Thankfully the growth has been minimal.
The decision that needed to be made was whether to go after another clinical trial or go for third line of defense chemotherapy drug. I have to say when I heard my oncologist refer to the chemotherapy as the third line of defense I thought football and what calling in the “third string” would mean let alone look like. Not an inspiring image. On the other hand the immunotherapy treatment only requires taking a couple of pills twice a day, there are no infusion’s and my oncologist tells me there are melanoma patients who had been on Pembro and are now showing positive results on CB-1158. The question was could I get on the trial? Praise God I start next week! The only thing I have to do is go back down tomorrow and have a biopsy done. Never thought I’d be thankful for the spot of cancer on my back but it makes for an easily accessible biopsy that can be done with nothing more than lidocaine.
CB-1158 is called an Arginase Ihibitor: In the tumor microenvironment, infiltrating myeloid-derived suppressor cells (MDSCs), macrophages, and neutrophils produce arginase, which depletes local arginine concentrations and dampens T cell-mediated immune surveillance. Pharmacological inhibition of arginase is expected to restore arginine levels and allow T-cells to proliferate, thereby leading to an immune-mediated anti-tumor response.
This decision also helped with another I needed to make and that’s what to do about the pleural effusion in my left lung. Any surgery would preclude me from participating in the clinical trial for 2 months so doing the VATS pleurodesis was out of the question. Which really only leaves the Pleurx catheter. Thursday Robin and I will be heading down to Georgetown in the morning so I can have it installed. Hopefully over the next 30-45 days pluerodesis will happen naturally, from keeping the lung drained.
Thank you for the continuing prayers.