This past week, I managed to squeak through the last cycle of my consolidation therapy. It didn't look too promising on Monday, as my neutrophil count had dropped to 1.1, barely above the minimum to take my Velcade push. My WBC was also at a low of 2.3, down from 4.2 the previous week. I went back in for my final visit on Thursday expecting to have the treatment halted or delayed, as had happened on the previous cycle. However, my counts rallied somewhat, so I was able to get my last dose of Velcade and continue my daily Revlimid dose of 10 mg. Tonight is the last night for the Rev, and tomorrow is my last dose of dexamethasone. Thank goodness for that!
As a side note, Revlimid, as you know, is a very expensive drug. Fortunately, my stem cell transplant clinical trial has been picking up the cost of the Rev, so I'm not making copayments for it now, as I did before. However, Celgene really likes to keep track of every pill. If I have any left over after a given cycle (which I now do, since in Cycle 3 I missed some days and they also dropped my dose from 15 to 10 mg/day), I am supposed to call them and send the remainder back to them. Given that these pills cost a few hundred dollars each, I have been reluctant to just pack them up and send them back. Who knows when I might need them, right? I'm kind of glad that I waited, because last night, I dropped one of these precious pills into the drain of the sink while I was up at the Farm for the weekend, and I could see it floating in the trap down below, just out of reach. Oops! Gonzo bonzo! So tonight, I will raid my excess stash to finish out my final dose for this cycle. They'll never miss them, right? They'll have to pry them from my cold, dead fingers, to borrow a phrase.
I'm not quite sure what comes next. I go in next Monday (August 27) to have some tests done to re-stage my condition prior to embarking on my next phase, which is Revlimid only maintenance therapy. I don't know whether these tests involve another bone biopsy or not. If so, I'll just suck it up and go for it. I am curious to see whether all this treatment has finally eliminated the cancer from my system. Somehow I doubt it. My immunofixation results keep coming back every cycle with the same result: "Monoclonal gammopathy with faint free Lambda paraprotein". It seems like I just can't quite get rid of this monster, no matter the transplant and all the drugs I've been taking. It's a bit disappointing (to say the least).
There have been a couple of interesting developments on the MM front recently. First, my miracle drug, MLN9708, now has an official name. It will now be called ixazomib. Like all those other drug names, this one just rolls off the tongue, doesn't it? I'm not quite sure that it is an improvement. At least is shows that there is progress with the drug and that the trials must be going pretty well to give it a generic name at this time. Go ixazomib!
The other news relates to the supposed miracle drug, JQ1. I blogged about this last November 3: JQ1, Miracle Molecule?. There hasn't been much news about it recently, but the latest splash is that this may be the long-sought-for male contraceptive drug! I read about this discovery recently in the news, but I didn't realize that it was the JQ1 drug they were referring to. That's nice, but what about the myeloma research? I'm sure there's lots more money in the male contraceptive market than in the MM market. Does this mean they will stop funding the MM research? I hope not, but one has to follow the money, right?
I plan to follow up with a couple of research areas soon. I will update my findings regarding a potential relationship between MM and Lyme Disease, and I will also keep you updated on the curious disappearance of all clinical research into anti-IL6 drugs for MM. I'm still scratching my head on this one. Stay tuned.