Wednesday, June 29, 2011

Radiation treatment is complete. But what about BRAF?

For those of you who have friended me and have been following me on Facebook, you know that I've been back to see the radiation oncologist and decided to receive another round of treatment. This time I was treated with CyberKnife technology which is a lot more accurate and allows us to hit a more defined area of cancer with even more radiation. I will likely receive more intense side effects than before, but the treatment area is smaller so the long term effect would be minimized.

This morning, I finished my second and final CyberKnife treatment for this round. Now we wait and see what happens. I'll go back and get another CT on August 25 to see the status of the melanoma in my leg.

I also just this morning received a call from Dr Spira, who indicated that I do in fact have the BRAF mutation! The number seems to change based on who you speak with, but considering that only 20 - 30% of melanoma patients have this mutation, I am quite lucky to be one of those.

This news of course opens up new opportunities for me on the treatment front. The recently named Vemurafenib from Plexxikon, formerly known as PLX4032, has been making headlines of late showing amazing durable remissions in treated patients. You may remember my TV interview when Vemurafenib made it's media break through. I'm pretty excited about finally being eligible.

There of course some caveats. Dr Spira believes that I will "get more mileage" from the BRAF drug over my current Ipilimumab treatment. There are rules that prevent one from being on both drugs, so once we find a program to have me enrolled, I will stop receiving Ipilimumab, possibly for good.

So far the closest treatment facility appears to be in Philadelphia. What's nice about this drug is that it is a pill. I will have a vial of pills, and I'll simply take two pills a day. Forever.

For many who have been on the drug there is a window of time where the drug remains active. Because cancer doesn't play by any given rules, it is also well known to stop responding to this treatment where the cancer then comes back, usually more aggressive. Worse yet, if this happens we are at the end of treatment options. That's it. That's all we have.

There are documented cases where patients who have been receiving this drug and have shown continued durable complete responses for well over two years. All we can do is hope that I can be part of that group.