Monday, September 12, 2016

Yeah Science!!!

I know what you are wondering as you woke up this morning, sipping your coffee...."Hey Mike, now that you are Programmed death-ligand 1 (PD-L1) also known as cluster of differentiation 274 (CD274) or B7 hololog (B7-H1) negative, are you going with ipilimumab and nivolumab?"     

Yeah Science!!!    

Why yes......that IS the plan!    Dr. Patel emailed last Friday and said my PD-L1 test came back negative.   (I swear to you, my first thought was 'I failed another test!!!')    We were waiting for the PL-L1 test results to narrow down the 3 options that were available, and being PL-L1 negative did just that.    So here is the plan:

Flying down to Houston Tuesday afternoon
6:45 bloodwork
7:15 Brain MRI with contrast 
Wednesday 2:30 meeting with Dr. P
3:00 start infusion of nivo/ipi

The infusion takes 3 hours.   About 30-60 minutes for each drug, then they stare at me for an hour to make sure nothing odd is happening.

Last night at "Cousin's Dinner"........   (cousin's dinner is Sun night.   My cousin Chris and his family meet my fam, Jenny's family, Emily's family when they can make it, and the rare appearance from my parents for a very casual dinner, last night was at Fuddruckers.   We have been meeting for "Cuz dinner" for 15+ years).......some asked about nivo/ipi, so I'll give a brief breakdown.

nivo is nivolumad (Opdivo) and ipi is ipilimumab (Yervoy).   Several years ago they were approved to treat Stage III and Stage IV melanoma separately, and both had moderate success.   Last October they were approved to be used in combination.    Think of it like this, nivo is chicken, and ipi is steak......I just ordered the combo fajita plate!    Both are immunotherapy drug, or checkpoint inhibitors.   Here is a good article on the nivo/ipi combo when the FDA approved them.   chicken/steak combo fajita platter FDA approved

So I now wait for Wednesday at 3:00.   In the past I've known exactly what to expect.   Surgery at 7:00 am at the Carroll Clinic......arrive at 5:30, don't eat anything.  Sadly I can say "hi" to about half of the people at the Carroll Clinic, but the good thing is it's a known entity.   I've got that surgery routine down to a science.   (hit 'yeah science' link above again)   This is a different animal, and doing it in Houston adds to the unknown.  Hopefully the sides effects are as easy as Shane Buechele dropping a perfect pass to a streaking receiver down the sideline, and not as difficult as a Texas Tech defensive stand.

So there is the latest update.   Thank you VERY much to Uncle Bill and Aunt Emmy for the flights to Houston!   Thank you everyone for your kind notes and prayers.


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