I am now almost nine months out from "cell day", July 1, 2015. This week, I met with the docs at NIH for my sixth follow-up.
While the results were mostly good, the one tumor that showed up "hot" on PET in October is now very obviously growing. Of seven tumors scattered across my lungs, only this one seems to have not gotten the message that it's time to bounce!
Why did this one tumor not respond to therapy? That's what we hope to discover. My next visit to NIH will (we think) include a procedure by an interventionist radiologist. Though a needle biopsy is theoretically the least invasive means to obtain a tissue sample, my last experience with an I.R. was less than pleasant. By a lot. I have some mental hurdles to overcome before my return to the operating room.
Once the scientists have a sample of the rogue tumor, they'll test it for mutations. If a couple of parameters are met concerning the properties of the tissue sample, a cell therapy may already be available for me. I would undergo the preparatory seven days of chemo, like last time, and then have a different population of cells returned to me. This population of cells was "Set B" from my prior lung wedge surgery. "Set A" were the cells they ended up returning to me in July, but these other cells also reacted to the KRAS G12D mutation. They could potentially be just the ticket for getting this final tumor to start shrinking away.
It is possible that the tumor does not have the two properties we're looking for. In that case, we will have to discuss what the next steps should be. Way-smart medical types are already contemplating all of this, and though I have some inkling of what could be next, I can't address that yet.
It was an emotionally draining day in the clinic (!), but it was encouraging, too. It was far from the worst news I could've heard. My over-arching thought is: There must be More to Learn from my case, and that is a pretty great thing.
Other results: The rest of the tumors remain stable. By RECIST, I'm still at 46% reduction from baseline. No new tumors were seen. TIL therapy is working, at least partially. For that I am excited, and grateful, and ever-more hopeful that it will work for me a second time.
If you pray, please pray especially for the team of doctors and scientists connected to my case. Pray for revelation to complement the determination they already possess. Pray that they do their best work. Pray that I, and they will cooperate with Divine Grace for the outcome that God wills.
Whew. That's a lot of prayers. THANK YOU!