Carboplatin/taxel ABT-888 clinical trial

I saw Dr. Puhalla today. She seemed very upbeat about this new therapy working for me. She said there was a narrow window of eligibility for this particular trial and I fit into it.

1. I couldn't have had taxel previously (I haven't)
2. I couldn't have had more than two kinds of therapy for the cancer in my lungs (I haven't).
3. My kidney function has to be perfect (okay...we're working on that).

There aren't any open spots right now in the trial but they expect one to open up in the next 3-6 weeks. She said it wasn't a problem to wait that long but if it were to go past 6 weeks, I might want to consider starting a chemo treatment while waiting. One that wouldn't infringe on the trial.

This is how the PARP Inhibitor (ABT-888) was explained to me. You have DNA in your cells. Each cell has many mechanisms to repair itself if it gets "hurt". Cancer cells have fewer mechanisms but multiply faster. Some stop working because of the chemo but the cancer cell has another one (PARP) to fall back on to repair itself and keep on growing. This is especially true if you have the BRCT gene (hope I got that right), which i don't or if you're triple-negative, which I am.

The pill, the PARP inhibitor, stops that fall-back mechanism from working. It works in tandem with the chemo to shut down the cancer cell's ability to repair itself and it dies. Sounds like a plan to me!

I googled carboplatin ABT-888 and actually found out what the trial consists of in the UPMC system. I would start course 1 (chemo #1) by taking the carboplatin chemo for 30 minutes and then the taxel chemo for 3 hours. It will be an all-day affair because they will take my blood every hour to check certain levels. Good thing I have a port so they don't have to stick me each time. Three weeks later, I will start course 2. I will take the PARP pill twice a day for 7 days. On the third day, I will have my chemo treatment 30 min/3 hours and will be there all day while they test my blood to see how I handle the addition of the PARP pill. These first two treatments will be done at the Hillman Cancer Center in Oakland (part of Pittsburgh). Once they determine that I can continue with the treatments, I can transfer back to Magee-Women's Hospital. I will get Dawn, my previous chemo nurse. The treatments won't be all day, just however long it takes to administer the chemo. I think that I would undergo 6 treatments in all.

Dr. Puhalla said that there were very few clinics in the country administering this trial and they had people coming in to Pittsburgh from all over to participate in it. Next time I complain about having to go to dahntahn Pittsburgh, I'll remember that.

In regards to my kidney function, I have to work on hydrating myself. I don't drink that much during the day. I've always been yelled at about that. I have a glass of water with breakfast, one with lunch and one with dinner and that's usually it. I don't drink much pop and sometimes, instead of water at meals, I drink plain unsweetened iced tea. I need to push the fluids big time to get my creatonine (sp) down to 1.0 or lower. When I was in the office on the 12th, it was 1.2. When I saw the renal doctor for the last time on September 8th, it was .90. Dr. Puhall said that it could be because I wasn't drinking enough. I know I don't. I took Bill's Brita pitcher that he had at school and bought new filters for it tonight. It will be sitting on my desk at work to remind me to drink more.

I had been envisioning that I had 5 spots on my lungs and some in the lymph nodes between the lungs. I was trying to zap them with brain waves (can't hurt!). I asked Dr. Puhalla today if I could see the PET scan and see the spots. Unfortunately, there were many more than I was imagining, between 20 and 25. However, they weren't as big as I had imagined. I'll take that as good news. I didn't want to see the spots on the 12th as I was still in so much shock. I needed to put some time behind me.

I am extremely encouraged with today's appointment. To all who ask "how are you feeling?" I feel fine. I have no symptons, no pain, etc. This does not mean, however, that you need to stop putting me and my family in your prayers. I appreciate all the help I can get!

A friend of mine told me what his mother said to her cancer doctor when he told her she had only 6 months left. She said "I'm not done pissing off people". She lived another 10 years before it got her. Those who know me, also know that I am not done pissing people off....

And...in case you noticed, as of this post, I've decided to stop using initials for people. I'm gonna call them who they are. Dr. Lembersky is Dr. L, my medical oncologist. Dr. Puhalla is new to me so I hadn't called her by her initial. Dr. Z, my surgical oncologist, is Dr. Ziauddin. His name is too hard to say for most people so his office called him "Dr. Z".

Anyways, *I* feel good about today and excited to start this new journey. Just hope it doesn't take too long.

Take care peoples.

Suesan