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Tuesday, December 23, 2014

More Farber

Last Wednesday I went to the Farber to follow up on my iron Dextran infusion.  My results are still good.  All my iron and anemia numbers are still up in the normal range.  I have been feeling really good lately, and I have more energy than before.  I am not napping as much now, so that's positive.  Samira recommended that I still take iron pills (maybe every other day), just to keep my numbers in the normal range. OK, so I should be in good shape on that front for a while.

 Thursday I went back to the Farber again to attend the last Writing Workshop.  I have been doing these workshops for the last 3 years, and I have found them to be emotionally intense, as well as really helpful and refreshing.  Amy, the moderator, now has extra duties at Boston College, so she can't keep doing this.  Too bad...she has been great!  I will miss the group and her monthly writing challenges, which have been inspiring.  This time, Amy challenged us to write a "6-word memoir".  Legend has it that Ernest Hemmingway was once challenged in a bar to write a tragedy in only 6 words.  He responded with, "For sale: baby shoes, never worn".  Since then, this has become somewhat of an art form.  There are several books on this, one of which is entitled, "Not Quite What I Was Planning".  Anyway, in response to the prompt, I wrote:  "Thought I knew.  I was wrong".  I will miss these gatherings.

Today I had my monthly visit and bi-monthly Zometa infusion.  Thankfully, my numbers are all still good!  While there, I ran across Kathy Colson, the RN who managed the MLN9708 trial that I started on 3 1/2 years ago.  She said she often thinks about the incredible coincidence that got me into that trial on my first visit to the Farber.  Their original candidate, with the initials WO, had just backed out.  Since they had already submitted him using only those initials, the only way they could replace him was with someone with the same initials.  What serendipity!  I still shake my head when I think about this.  Kathy still marvels about it.  The rest is history.  I  responded really well---MLN9708 hit a home run with me.  What a lucky son-of-a-gun I am!

That reminds me of the story of James Bond, a long-term MM survivor, who spoke at the Farber Patient Symposium a couple of weeks ago.  He was in dire straits and out of options when he got into the first clinical trial using the new wonder-drug, Velcade, with Paul Richardson about 10 years ago.  It was a long shot, but everyone thought it was prophetic that the trial number randomly assigned to him was 007!  Miraculously, he's still here, a testament to serendipity and the effectiveness of the recent advances in MM therapies. 

I promised to give an update of the recent ASH Conference held in San Francisco.  Talking with Kathy today, we discussed the recent clinical trial results with MLN9708 (Ixazomib) presented at ASH. The results have been fantastic, and The FDA may approve it as both a front-line and R/R treatment in 2015.  It's a great drug, with the advantage of being pill not an infusion, and I was fortunate to be part of the initial Phase I trial.  It may eventually replace Velcade as the treatment of choice for MM.  Thank you, Paul Richardson!

At the Farber's Patient Symposium on December 13, Ken Anderson summarized the future of novel agents against MM.  The most promising future agents are the monoclonal proteins.  Elotuzomab (anti CS1) and Daratumumab (anti CD38) are both showing great promise. Another promising agent is SAR650984 (anti CD38).  Immunization therapies have also come a long way.  One use of these is in early stage disease, such as MGUS and Smoldering MM.  High-risk patients in these categories may benefit from early intervention before progression to full-fledged MM.  For patients with advanced MM, suppression of the baseline immune system can inhibit the effectiveness of immunization therapies.  However, recent advances in using the PD1/PDL1 blockade may enhance the effectiveness of immunization, allowing the body's own immune system to target the MM cells.  There is still a ways to go in using cytogenetics to provide individualized treatment regimens, but the future is very promising in this arena.

We are awaiting the arrival of our family for the Christmas holiday.  I'm excited!  Jason may come in from Connecticut late tonight, and Holly and Ryan are arriving from San Francisco tomorrow morning.  Jeff and Christine will come over tomorrow and we will have Christmas Eve and Christmas day here, celebrating our last get-together in this house.  The menu includes smoked ham and egg plant parm tomorrow and standing rib roast Christmas day, along with Yorkshire pudding, lasagna, calamari salad, and a lot of other stuff I forget.  Needless to say, we won't go hungry.  Brian, Pam, and our grandson, Logan, will be coming in on Sunday to spend a few days, so I'm looking forward to spending a relaxing week with family.

Then comes the closing on our new house on January 2, and we have to start packing and moving.  In the meantime, we'll just try to enjoy. 

It's all good!

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