Thursday, February 10, 2011

Another one down, two to go....

Last Monday i received my 3rd from the last dose of Avastin. The penultimate dose will be Feb 28, and the last dose March 21. Great to be nearing the end of the protocol.

With excellent timing, a friend sent me another news release from Roche (the manufacturer) stating that Avastin combined with chemotherapy has now been shown to significantly increase disease free survival in 3 large stage III trials. Stage III are the final trials where safety and efficacy have been established and these enroll large numbers to see if the efficacy findings hold up and the safety profile remains stable. This is excellent. There was discussion in the news clipping about whether Avastin would get FDA approval for the indication of ovarian cancer, because it is expensive and while it has been demonstrated to prolong disease free survival (the duration of time before disease recurs or comes back), it has not apparently been demonstrated to clearly extend overall survival.

For me, I know what I would argue for if the FDA wanted to bring me in as a patient representative. What I am focused on is disease free survival, as I continue to wait for my chemotherapy-induced neuropathy to receed and my strength to return. I don't think in terms of time to death or wonder how long I will survive. I think in terms of time until recurrence and wonder how much time I will have before I have to return to chemotherapy again. And I hope it will be long enough to regain my strength, complete the organizational, planning and other tasks that I need to prepare, have my neuropathy go away at least enough to allow me to travel and maybe dance and scuba dive again with out excessive limitations. There were many blessings and lessons contained within the experience of chemotherapy. But I think I learned them the first time around and am less optimistic that a second round will be a time of learning and progress rather than a time of ... marking time and resting because i can do little else. The ability to be productive, to travel, to take care of business or to just go out to have fun that I measure is the time between now, when I have finally reached a physical point where I can begin to do intentional exercise (half hour at a time and very very mild, but still...) and the point where disease recurrence will push me back onto chemo. It is not the time between now and the point when I cease to breath.

So I would argue that an increase in disease free survival is more meaningful than an overall increase in survival, if FDA wanted to ask.

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