So about this 20% business.
Today I am in hospital today for Cycle 2, Day 1 of the clinical trial, and I had a word about the whole 20%-growth-and-you’re-out thing with Naz, my incredibly competent, compassionate and sensible nurse.
She sat down on the bed and looked me in the eye, and asked in a way that I hope I remember to employ when reasoning with my future teenager: “Well, what would you want to do if the CT scan were to show that these lumps are growing? Would you want to continue with a drug that isn’t working for you?”
No, I admitted, I would not. I would however like the drug and I to be given a fighting chance of working together toward the common goal of cancer obliteration (apoptosis!) before we are ripped asunder. I’ve tried chemo and radiation, and now I’d like a fair shot at the wonderful world of HDAC-inhibitors. Perhaps they could just adjust the dose?
Negative. This clinical trial, as Naz explained, is at a stage where the dose has been firmly established based on things like toxicity tolerances and disease response, and they’re just not going to give me more than I’m getting right now, period. But they do want to give the drug a chance to do its thing, which is why they’ll wait a full two cycles to see if it’s working.
A full two cycles. That may sound generous but it boils down to just four doses total, next Wednesday’s being the last. The CT scan is already booked for the following week, August 26th. Clearly Panobinostat and I are on the clock.
Take heart: I actually think we can do this. I’m going to go with the idea that this is the beginning of a long and mutually satisfying relationship between me and Panobinostat, rather than a whirlwind summer fling. Bonnie & Clyde, Batman & Robin, Leanne & Panobinostat. I do the tough talking — Shrink, damn you. You’ve got 2 weeks to make like a couple of raisins and shrivel — and Panobinostat is the muscle.
Cancer, you’ve been warned.