The options we were offered were the brivanib trial (an oral anti-angiogenesis drug) and a phase I of an mTOR inhibitor (everolimus) combined with cisplatin. It turned out that the phase I was filled -- so brivanib, here we come.
We need to fight with the insurance company -- unlike Ariad, the drug company for this one is not footing the bills for doctor visits and scans -- and do a bunch of screening tests. I'll be in New York again on January 2, and will continue with weekly visits for about six weeks. After that the visits will be every three weeks. The brivanib trial has a pretty wild protocol that allows for a placebo control while minimizing or eliminating time spent off-drug if the agent is helping. Alas, I'm too tired to get into that right now, so you'll have to wait for the next exciting edition. The trips will be expensive and, probably, difficult, but being in New York City weekly is sort of a dream come true for me, so I'm trying to emphasize that part of it and ignore the fatigue and money.
Amusing, semi-classic Dr. BT moment from the trip: He and his fellow were apparently eyeing my lungs with some concern and disbelief, so he ran upstairs to consult with a thoracic surgeon. I have my issues with Sloan, but the multi-disciplinary teams and intense specialization of the people there is one of the cool aspects of the place. Anyway, he comes down and says the guy thinks a chest tube might be worth a shot, and maybe VATS on the left side if the tube can bring the lung up successfully. We then have this exchange, abbreviated only slightly:
"He has concerns about you flying."
"I admit that it's occurred to me that I might throw a PE or something."
"No, no: It's the pressure differential. How did you get down here?"
"Uh... I flew. Should I be concerned?"
"Well, you have to get home."
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As always in NY, there was some room for joy. We ate here, like always, and nearly missed our flight (despite arriving at the airport two hours early) because of an ordering mishap at the new tapas bar that led to us receive one-and-a-half liters of sangria rather than a half liter. You know, we couldn't waste it. So L. and I ended up charging off together, hand-in-hand and half-stumbling, to the closed gate.
It's kind of cool that I can stare my mortality in the face for two years, survive an untold number of physical and emotional traumas, and still manage to be the same immature jackass I've always been. That's talent.
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Bonus post segment: The wit and wisdom of a naughty boy (part one of a five-part series):
"B., are there any new clothes you'd like for Christmas?"
"Yes: a tuxedo!"
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