I took my 70th Gemzar infusion in my 22nd month on it as single agent first line, and then had a CT. July is the two year anniversary of my Dx in July, 2011.
I think I now have the unofficial Gemzar record over D, except that D is NED and I have had my first progression. A small nodule that had been stable and not hypermetabolic since my inital Dx PET/CT grew 1cm. Always described as "adjacent" to the primary, it now has grown that 1cm into and joined with the mass.
My onc wants me to take advantage of this small progression (less than 20% on RECIST baseline measurements) to go for the Merck MK 3475 Anti-PD-1 trial. He thinks, if I have the protein, that my small tumor burden and the great shape Gemzar has left me in would be a big advantage. Gemzar can't last, so go for it now. Any other chemo he says will violate my Q of Life priority, and you can't hope to be a super responder again. Plus the median to progression is horrible on all my options.
I had some big reservations. You have be off chemo a month before the biopsy, and what if cancer takes off without Gemza?. And if I don't have the protein, then what, only a more toxic option. And what if the biopsy fails, I had 3 before they could figure out I had adenosquamos, and 2 collapsed lungs, minor, on the needle version.
So we decided to go for 2 more months, not the usual 3, and then another scan. If I progress further, I am forced to go for MK 3475. I have had these scares before, and they were resolved on the next scan, but I think this one with the nodule reactivating is real. But maybe shrinkage? maybe stability? We'll see. Another part of my argument to continue is that all my lymph nodes are normal size, so Gemzar still working. On my Dx PET/CT in July, 2011, almost every lymph node in my chest had adenopathy. So I'm content with the decision and grateful to my onc that he does listen to me, but he has refused a 2 on, 1 off schedule. I remain on a 3 on, 1 off, and maybe that is the right thing to do.