Mark's Melanoma Journey: Last Day of IL-2

Because Mark did so well, he got THREE doses of Interleukin-2!!! Dr. Taylor expected only one, so he was thrilled. But no more--this aspect of the treatment is over. Yea!!! The rigors were the most challenging part for Mark. The first time was the worst, and yesterday's was pretty bad. Dr. Taylor and Roxanne were here yesterday during this episode, so they saw how awful it was for him. He told us that we'd see how his labs were, and if it looked good, he could have one more, but he would leave the decision up to us (Mark--I'm not making that call!) This morning they came in, and Mark was willing to go through it one more time. Dr. Taylor had already told us that three doses would be the limit.

The nurses were ready with warm blankets and Demerol but were out of the room when the rigors started. As soon as Mark exhibited the first signs of chilling, I found them, and they came running. Perhaps because they were on it so fast, it was not nearly as bad as the prior two! That was such a tender mercy, as he was really dreading it. Now, he is sleeping peacefully with between 15-20 blankets piled on top of him.

He is now receiving daily shots of Filgrastim to treat neutropenia (low white blood cells) caused by the chemo. "It is a synthetic form of a substance that is naturally produced in your body called a colony-stimulating factor. Filgrastim helps the bone marrow to make new white blood cells." It has a long list of side effects, as well, but it's essential to get his immune system up and running smoothly again. Claratin, the allergy medicine, is actually used with it, as it combats some of the side effects.

Dr. Taylor said that his white blood count is still going down and should hit the lowest level in a day or two, and then it will start shooting back up. When it's back to a safe level, he can be discharged, which could be as early as the middle of next week, but more likely the end of the week.

Now some explanation as I understand it about T-cell therapy. There are different kinds.

TIL (tumor-infiltrating lymphocyte) therapy is a treatment in which "tumor-infiltrating lymphocytes (a type of immune cell that can recognize and kill cancer cells) are removed from a patient's tumor and grown in large numbers in a laboratory. These lymphocytes are then given back to the patient by infusion to help the immune system kill the cancer cells." This treatment has been around a long time and has had many positive results. The problem is that many T-cells in the tumor are grown along with the specific ones that actually recognize and kill cancer, so the percentage of actual cancer-seeking warriors is low.
CAR-T is "A type of treatment in which a patient's T cells are changed in the laboratory so they will attack cancer cells. First, T-cells are taken from a patient's blood. Then the gene for a special receptor that binds to a certain protein on the patient's cancer cells is added to the T-cells in the laboratory. The special receptor is called a chimeric antigen receptor (CAR). Large numbers of the CAR-T cells are grown in the laboratory and given to the patient by infusion." This has had great success with blood-type cancers but does not do so well with solid tumors. The T-cells seem to be killed by the cancer cells when they enter the tumor.
ACT (adoptive cell transfer) is a therapy in which T-cells are taken from the patient's own blood, grown in large numbers in the lab, and infused into the patient’s body.

Dr. Tran is doing ACT therapy, except he finds the exact cells that recognize cancer by putting small amounts of cells into Petri dishes and using proteins that mimic cancer as bait to see if the cells attack. This is very time-consuming, and often the cancer fighters are never found. Only two of these cells were found in the blood taken from Mark's body, and those two were not exactly the same. Those specific cells were cloned, resulting in 12.78 billion cells, but only about 7.5 billion will actually attack cancer. The others just tag along. They didn't develop into warriors.
This is a trial therapy--it has not been approved for general use. However, Dr. Tran has been working on this treatment for years and is eager to see positive results and have it approved to benefit more patients.

If you were confused about how this therapy is different from other T-cell treatments, hopefully, this explanation helped a bit. It's all very scientific and definitely cutting-edge research.

Since Mark got fewer drugs today, he is awake and feeling quite good, other than weak. If there are no more snags, he should be on the road to recovery! It could be months before we know if this treatment is working. If it's not, we'll probably know sooner, although he is still taking the Braftovi and Mektovi along with this since his tumors were growing too fast for this to work without them. He will have to go off of the targeted drugs at some future date to see if this treatment has been successful. Dr. Taylot said that we should definitely write a book about all of his cancer treatments and successes!

Thank you so much for your unending love and support!

Before IL-2 (look at all those bags!)