B is the word.

By , on October 9, 2011

C Word


I’m about to add a new chapter to my cancer treatment story.

For those who have come in late:  in January 2008 I was diagnosed with Stage 4 follicular lymphoma, type 3. I was treated from January to May with a regimen called R-CHOP.  The R is for Rituximab, a monoclonal antibody that causes the body’s immune system to attack the B cells that cause the disease.

Despite the apparent success of that treatment, by fall 2009 it was clear that the disease had revved up again.  In February 2010 I began treatment leading up to a stem cell transplant on May 26 2011 (my new birthday).  An SCT is a harrowing process involving lots more chemo and radiation.  Most of this blog is about that treatment, which was successful in eliminating any evidence of the disease.  But with follicular lymphoma they never use the word “cure”.

I had clean scans in late 2010 and March 2011, but my September 2011 scan showed a couple of small nodes growing near my aorta.  This news was, shall we say, disappointing, as I’d hoped to get a few years of disease-free living from the transplant.  It’s always something.

So on Monday October 10 2011 I’ll be starting a new round of treatment.  This regimen has its very own webpage at clinicaltrials.gov because it is indeed a clinical trial.  This doesn’t mean that I have exhausted other forms of treatment and am now cast adrift on the uncertain seas of trials.  Only one of the three drugs in this regimen is really new.  One of the other two is good old Rituximab.  Another is Bendamustine, which is new to me but in the last couple of years has become the standard of care for FL.  If I were newly diagnosed now with follicular lymphoma I would probably get R+B rather than the R-CHOP I got in 2008.  So most of this regimen is business as usual.  The trial drug, TRU-016, just adds a new wrinkle.  It is another monoclonal antibody that attaches to a different protein (CD37) than does Rituximab (CD20).  You can read the abstract:

Furthermore, the triple combination of TRU-016 with rituximab, bendamustine or temsirolimus displayed greater anti-tumor activity in vivo than each of the agents alone against a follicular lymphoma tumor model.

Sounds good to me.

The claim is that all these agents are well-tolerated and that others getting them report little to no side effects.  We’ll see how I do.  At least it’s unlikely I’ll lose my hair again.

On the other hand the point of this phase of the trial is to investigate “dose-limiting toxicity” of TRU-016 which has an ominous ring to it.  But according to the doc this is just something they have to do to qualify the drug, there’s no reason to think that it would be toxic at any conceivable dose; so the only limiting factor in dosage is cost …

If all goes well I’ll get treatment in 4-week cycles, 6 cycles in all, ending in late March 2012, just in time for the Paris IETF; maybe even the Coupe du Monde de la Boulangerie.

More news as it happens.



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