Mets Day 1014: Wheels in motion for the MPDL3280a trial

This morning I spent a good deal of time lining things up for the MPDL3280a clinical trial.  Last night I had sent an email to Dr. Aragon-Ching  summarizing the day's events, asking for her clearance to restart the Xarelto, and seeking her input on which clinical trial I should enter. She called me this morning and we had a good discussion about my options. Regarding clinical trials, she said that she saw three options for me: Dr. Apolo's cabozantinib trial, the immunotherapy trial with MPDL3280a, or another regimen of chemotherapy. She then recommended holding off on the chemo until I really needed it, i.e., when I had lots of tumors in my organs. She noted that there were some trials combining platinum-based chemo regimes with taxenes, which is something we previously had discussed in 2012 and 2013. Apparently the research is still going on taxenes. For now, she agreed that I should look into the MPDL3280a immunotherapy clinical trial. She offered to contact Dr. Dawson at Georgetown on my behalf. She also endorsed my resuming the Xarelto.

While I was talking to Dr. Aragon-Ching on my land line, Dr. Dawson's research nurse called my cell phone. Dr. Dawson apparently had been emailed by Dr. Apolo, and asked her nurse to follow up post haste. I returned her call, and got the wheels turning for seting up an appointment with Dr. Dawson. The nurse emailed me Georgetown's 11 page new patient form, which I completed and returned. I also filled out the NIH records request form, asking that they overnight all of my records to Dr. Dawson, and NIH confirmed that it would do so. Once Dr. Dawson's nurse receives them, she'll schedule an appointment, probably some time next week. It's great when things fall into place quickly. I am grateful to my doctors for looking out for me and acting quickly to enlarge my team when appropriate.

Faithful blog readers may recall that I have been following news about PD-L1 research for some time. Back in September 2013, when I was considering whether to do dose dense MVAC, my oncologist at Fox Chase Cancer Center advised that I research the emerging trials involving PD-L1. In May of 2014, I had a conversation with Dr. Aragon-Ching about emerging therapies, and she said that the most promising research was with regard to immunotherapy and the PD-1 and PD-L1 inhibitors. In Spetember of last year, she gave me a set of slides from a presentation she had just given regarding the PD-L1 clinical trial that I am now investigating, and told me at that time that, once my nodes were sufficiently large, she thought that was probably the best option for me. Now that I'm at that point, it seems that is the most reasonable choice.

I also reviewed several of the posts regarding patients actual experiences with the MPDL3280a trial on BCAN's forum at www.inspire.com. The comments mirror the preliminary results - some patients credit the drug with stopping their metastatic disease; for others, it did not work. But the data indicate that about 50% of patients with metastatic disease see at least some slowing of the disease. Until there is a cure (and we are a long way from that point), slowing the disease down is the best I can hope for.