Cancer is Back

2017 isn’t off to a stellar start.

During today’s appointment with my oncologist at Memorial Sloan-Kettering Cancer Center (MSKCC), we received disappointing news that the biopsy of my chest lymph node contained the same cancer cells (squamous cell carcinoma) as the original tumor in my tonsil. This means that the cancer has spread to distant sites and, unfortunately, cure is now no longer an option.

I enrolled in a clinical trial with Bristol-Myers Squibb’s Opdivo© (nivolumab), a type of immunotherapy called a checkpoint inhibitor, and should start treatment next week assuming I meet the study criteria. While the drug was already approved by the FDA for recurrent head and neck cancer, the study will evaluate whether or not adding targeted radiation directed at one single lung node can improve outcomes.Opdivo

I was already familiar with the synergy between radiation and other forms of therapy, especially immunotherapy. Coincidentally, we were exploring such synergies back at Cytogen Corp with the company’s skeletal targeted radiotherapy being combined with a poxvirus vaccine being developed by Dr. James Gulley at the NIH at the time. Small world.

As the trial is randomized, I may or may not be one of the patients to receive the added radiation therapy. However, both arms of the trial receive Opdivo – so I get an active drug in recurrent head and neck cancer in either case.

There has been a great deal of enthusiasm for checkpoint inhibitor products, such as Opdivo. However, in the recurrent head and neck cancer study by Bristol-Myers Squibb, the median overall survival was 7.5 months for patients that got Opdivo. The other patients that received standard therapy options (cetuximab, methotrexate, or docetaxel) had a median overall survival of 5.1 months. True, there were some ~20% patients that had durable responses with Opdivo, but the vast majority (80%) did not have a durable response.

The good news is that Opdivo is a form of immunotherapy and doesn’t have many of the severe side effects associated with both chemotherapy and radiation. Accordingly, it is expected that I will be able to continue working and not have any major issues throughout treatment, as they are rare. However, Opdivo can cause your immune system to attack normal organs and tissues in many areas of your body, and can affect the way these organs work.

I’ll be posting more updates in the coming week or so…

5 thoughts on “Cancer is Back

  1. Michael, I knew the results of the biopsy should be available either yesterday or today and have been looking for an update, but I was hoping for a more positive one than this one and that your prediction would be wrong. My heart is heavy, but I am also in awe of your strength in facing this latest diagnosis. I’m going to keep hope alive because without it, what is there?

  2. Michael, The news is heartbreaking. My heart is heavy as I know the road you will be taking. I believe you are definitely in the right place for the best tx possible and I also believe with your knowledge and strength you stand a better chance of dealing with this fucking disease. (sorry I just can’t stand it for so many good people to have to deal with this shit). As always you and the family will remain close in my heart and in my prayers. I only wish I could do more. Hold on to hope and know there are many of us out there for you and the girls..all 3!

  3. I will pray for you and your family. I can hear strength in your words and will pray for you while you fight this fight.

  4. Michael & Lorie
    My heart is heavy with this latest news. If I can do anything, I will. I could manage the house & girls so you two could manage the medical stuff. Just ask me if there is any way I can help.
    Much love,
    Susan Wilson

  5. Michael: I just learned of your condition and blog through BioNJ’s BioLines Weekender publication. I admire your measured and rational approach to your cancer and its treatment. I hope that you are one of the fortunate high responders to Opdivo, and that should you also get the targeted radiation, it is complementary in its effect. Best of luck! Mike Ultee

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