First Yervoy Infusion

This afternoon was my first Yervoy (ipilimumab) infusion, and it went quite smoothly. Yervoy is classified as a monoclonal antibody which is a “targeted” cancer therapy. Because it targets only specific cells, it may cause less toxicity to healthy cells, rather than chemotherapy that can be toxic to all cells.

When I had my interferon infusions at my first cancer center a little over 6 years ago, we all sat in reclining chairs in a big circle in a large room. At Hershey, I have my own little “room” with a curtain, a bed, small table, closet, and a couple of chairs. There are windows to a courtyard where I could sit outside. I didn’t want to be in the bed, so it was fine for me to sit in the chair and, when a recliner became available, I was moved to that room. I lost the view outside, but was much more comfortable in the recliner.

I had my lab work at 2:45 and went straight from there to the infusion lab, so I was early for my 3:15 appt. Till the room was ready, the paperwork signed and faxed to the pharmacy, and the IV started, it was close to 4:00. It was a 90-minute infusion and then a 10-minute flush, and we were out of there around 5:45.

Yervoy has side effects (most common are fatigue, diarrhea, and itching) that, if I get them, probably won’t show up right away. Some side effects could occur weeks or months after I finish the treatment. All I was given prior to the infusion was ibuprofen – no Benadryl or anti-nausea meds – and I feel fine. I actually could have taken my laptop and gotten work done rather than watch mindless daytime TV and lose a few more of my dwindling sick leave hours. Now I know. Next infusion is in 3 weeks.

Have I mentioned how happy I am to be at home?!

Ending one treatment and beginning another

It’s been quite a journey since I received my first pathology report of malignant melanoma back in December of 2007. I’ve had multiple surgeries including a sentinel lymph node mapping and biopsy and lymph node dissections, 19 treatments of intensive interferon, isolated limb perfusion at U Penn, 9 months of leukine shots, and finally high dose interleukine 2 (IL2) with temozolomide (TMZ). I made it through two courses of the IL2 and TMZ and was scheduled to be readmitted to the hospital for the third course to begin tonight. However, for the second scan in a row my disease is stable, and this treatment is too harsh to only get stable results. Stable is great because it means the cancer’s progression has been stopped, and Monday’s scan even showed that a tumor in my lung got a bit smaller and has less intensity (from black to gray on the printout). But it’s still not good enough to go through a third course. I feel as though I’m a bit too happy about not having to go through the third course, but it really was rough and I was quite stressed about having to go back into the hospital. It’s quite freeing to be sitting at the kitchen table with the screen door open right now!

The next step, which has been plan B for awhile, is to begin radiation on my leg and go through four infusions of ipilimumab (Yervoy). The infusions will be three weeks apart and will last about 90 minutes – all out-patient. That begins September 29th. I’ll know more about the radiation treatment and schedule after the consultation (still to be scheduled). Although the Yervoy has side effects, they’re all manageable and nothing like the IL2. It’s expected that I’ll be able to work through it all and feel good. I’ll get scanned about six weeks after the last infusion, so that would be sometime in January.

The oncologist explained the IL2 and TMZ as pressing the gas pedal down with the brake on. The Yervoy will release the brake. He has been administering Yervoy for about 3 1/2 years, and has seen Yervoy able to be more effective after a patient has gone through IL2. So I’m going into this treatment with an advantage. Add the radiation into that, and we expect to knock the cancer out! My volume of cancer remains small, so this is doable!!

We now have a new plan B and C, so if any cancer cells are left after this treatment, there are still more options. It’s nice to have options! My surgical oncologist told me that all I need to do is live long enough and the right drug will come along. Another new drug just received FDA approval last week (pembrolizumab – Keytruda), and the research continues for even more effective therapies.

Except for the IL2 treatments, I had a great summer and feel terrific. We feel immense gratitude for all the love and support we continue to receive – it makes ALL the difference! Thank you!!