Three weeks ago, Lisa had the first MRI scans of her brain since her neurosurgery. The report based on the MRI couldn’t have been better. The surgical site is healing nicely and there are no indications of new or progressing lesions.
She also had CT scans of her body and neck. The CT scans indicated that the disease in her lungs, lymph nodes, and bones remains stable. Unfortunately, the scan confirmed what Lisa had been feeling, a new mass in her poratid gland.
At that time, we agreed with her oncologist, that the best treatment option for her was to enroll her in a MGH Phase III clinical trial of a drug called T-DM1*. Since then Lisa has endured two trips to MGH and a barrage of medical tests in order to determine if she meets the eligibility requirements of the trial. The tests also set a baseline to track the efficacy of the treatment. Luckily, the doctors were able to use the recent MRIs and CT scans, but they needed a bone scan, an EKG, an echocardiogram, blood and other lab tests.
Although not required for the study, she also had a fine needle aspiration (FNA. What a lot of fun that was. Not! They only had to do it like six times!) of the lump in her parotid gland in order to determine what exactly is happening there. And it turns out that what is happening there is that her cancer has indeed metastasized to her parotid gland.
All the other test results came back within the required range except the echocardiogram which showed an ejection fraction** that was too low to qualify for the clinical trial. Her oncologist had her wait for a week and then retake the echo. The plan worked as her ejection fraction had risen just enough to qualify.
Today, we made a trip to our local oncologist’s office for a final set of blood tests. The results of which were faxed to the clinical trial people at MGH.
Assuming that the blood tests were within the required ranges, Lisa will be officially enrolled in the clinical trial. Once that happens she will be randomly selected for one of the two arms of the study. Two-thirds of the patients receive T-DM1 and the other third of the patients receive a standard treatment selected by their oncologist.
We will hear tomorrow which arm of the trial she is in. Until then, everyone think, “T-DM1, T-DM1,…”!
** Ejection fraction = Volume % of blood pumped out of left ventricle per beat.