We are off to Pittsburgh to start the toughest chemo to date.
All I can say is:
“Hit me with your best shot, fire away” Pat Benatar
Well you're the real tough cookie with the long history
Of breaking little hearts, like the one in me
That's O.K., lets see how you do it
Put up your dukes, lets get down to it!
Hit Me With Your Best Shot!
Why Don't You Hit Me With Your Best Shot!
Hit Me With Your Best Shot!Fire Away!
You come on with a come on, you don't fight fair
But that's O.K., see if I care!
Knock me down, it's all in vain
I'll get right back on my feet again!
Hit Me With Your Best Shot!
Why Don't You Hit Me With Your Best Shot!
Hit Me With Your Best Shot!Fire Away!
Well you're the real tough cookie with the long history
Of breaking little hearts, like the one in me
Before I put another notch in my lipstick case
You better make sure you put me in my place
Hit Me With Your Best Shot!
Come On, Hit Me With Your Best Shot!
Hit Me With Your Best Shot!
Fire Away!
Hit Me With Your Best Shot!
Why Don't You Hit Me With Your Best Shot!
Hit Me With Your Best Shot!
Fire Away!
Take Care
Jimmy B.
Tuesday, October 31, 2006
Monday, October 30, 2006
10/30/06 Melanoma 101 based on the Interlukin-2 Therapy
Page # 2
Dosage:
“One-hundred forty-seven patients received IL-2 720,000 IU/kg every 8 hours (four studies), 118 patients received 600,000 IU/kg every 8 hours (three studies), and five patients received either 360,000 or 540,000 IU/kg. Patients treated with the higher doses of IL-2 received fewer doses; consequently, the median cumulative amount of IL-2 for the first course of therapy was similar for each dose level (Table 3). Clinical factors such as PS did not influence the amount of IL-2 delivered. Patients received up to five courses of therapy (mean, 1.4 courses; median, one course), with 81 patients receiving more than one treatment course. Information on the number of patients treated and the amount of IL-2 administered per treatment course is listed in Table 4.”
Results:
“The median duration of response for all responders was 8.9 months. Response duration curves according to response classification are displayed in Fig 1. The median response duration for patients who achieved a CR has not been reached, with 10 of the 17 CRs ongoing at 24 to 106 months. The median duration of PRs was 5.9 months. Two patients who achieved a PR had ongoing responses of 55 and 92 months' duration. Although these patients were classified as achieving a PR and had persistent scan abnormalities at follow-up evaluations, they remained progression-free without further treatment. The median PFS time for all responding patients was 13.1 months. The median PFS time for patients who achieved a CR has not yet been observed but is at least 54 months. Fifty-eight percent of the responders remained progression-free at 12 months. The median PFS time for the patients who achieved a PR was 8.3 months. In 37% of the PR, the PFS time exceeded 12 months. There were no relapses in responding patients after 30 months.”
CR= Complete Response
PR= Partial Response
PFS= Progression Free Symptoms
Class will take 15 minutes recess!!!!!
Take Care,
Jimmy B.
Dosage:
“One-hundred forty-seven patients received IL-2 720,000 IU/kg every 8 hours (four studies), 118 patients received 600,000 IU/kg every 8 hours (three studies), and five patients received either 360,000 or 540,000 IU/kg. Patients treated with the higher doses of IL-2 received fewer doses; consequently, the median cumulative amount of IL-2 for the first course of therapy was similar for each dose level (Table 3). Clinical factors such as PS did not influence the amount of IL-2 delivered. Patients received up to five courses of therapy (mean, 1.4 courses; median, one course), with 81 patients receiving more than one treatment course. Information on the number of patients treated and the amount of IL-2 administered per treatment course is listed in Table 4.”
Results:
“The median duration of response for all responders was 8.9 months. Response duration curves according to response classification are displayed in Fig 1. The median response duration for patients who achieved a CR has not been reached, with 10 of the 17 CRs ongoing at 24 to 106 months. The median duration of PRs was 5.9 months. Two patients who achieved a PR had ongoing responses of 55 and 92 months' duration. Although these patients were classified as achieving a PR and had persistent scan abnormalities at follow-up evaluations, they remained progression-free without further treatment. The median PFS time for all responding patients was 13.1 months. The median PFS time for patients who achieved a CR has not yet been observed but is at least 54 months. Fifty-eight percent of the responders remained progression-free at 12 months. The median PFS time for the patients who achieved a PR was 8.3 months. In 37% of the PR, the PFS time exceeded 12 months. There were no relapses in responding patients after 30 months.”
CR= Complete Response
PR= Partial Response
PFS= Progression Free Symptoms
Class will take 15 minutes recess!!!!!
Take Care,
Jimmy B.
10/30/06 Melanoma 101 based on the Interlukin-2 Therapy
Page # 1
“MELANOMA POSES AN increasingly important health problem.
It is estimated that by the end of 1999, the lifetime risk of developing melanoma in the United States will have reached one in 75.1 Although surgery with or without interferon alfa (IFN ) therapy can be curative in stage I, II, or III disease, a large number of patients will develop distant metastases.
Disseminated metastatic disease is associated with a poor prognosis and a mortality rate of more than 95%. In several large series, survival correlated inversely with the number of involved organ sites, visceral involvement, the disease-free interval, and performance status (PS).2-4 Several treatment options are available to patients with metastatic disease, including single-agent dacarbazine (DTIC) chemotherapy, a variety of combination chemotherapy regimens, and combinations of chemotherapy with tamoxifen or IFN . DTIC chemotherapy produces responses in approximately 20% of patients, with a median response duration of 4 to 6 months, a 5-year survival rate of 2%, and a median survival time of 6 to 9 months.5 Although single-institution phase II studies and small phase III trials have shown that combination chemotherapy, or the addition of either tamoxifen or IFN to DTIC chemotherapy, has potential benefit, no regimen has yet proved superior to DTIC chemotherapy alone.6-13
Interleukin 2 (IL-2), a T-cell growth factor, was first identified in 1976,14 and isolation of the cDNA clone was described in 1983.15
Subsequently, recombinant IL-2 (rIL-2) was shown to have potent antitumor activity in a number of murine tumor models.16 Based on animal model data, a high-dose IL-2 regimen was developed in which IL-2 was administered by short intravenous infusion every 8 hours, with or without lymphokine-activated killer cells.17,18 High-dose bolus IL-2, as a single agent, received United States Food and Drug Administration approval in 1992 after demonstration of durable responses in patients with metastatic renal cell carcinoma.19 In this report, we describe findings from a recently updated 270-patient database of metastatic melanoma patients treated with the same high-dose IL-2 regimen between 1985 and 1993.”
“MELANOMA POSES AN increasingly important health problem.
It is estimated that by the end of 1999, the lifetime risk of developing melanoma in the United States will have reached one in 75.1 Although surgery with or without interferon alfa (IFN ) therapy can be curative in stage I, II, or III disease, a large number of patients will develop distant metastases.
Disseminated metastatic disease is associated with a poor prognosis and a mortality rate of more than 95%. In several large series, survival correlated inversely with the number of involved organ sites, visceral involvement, the disease-free interval, and performance status (PS).2-4 Several treatment options are available to patients with metastatic disease, including single-agent dacarbazine (DTIC) chemotherapy, a variety of combination chemotherapy regimens, and combinations of chemotherapy with tamoxifen or IFN . DTIC chemotherapy produces responses in approximately 20% of patients, with a median response duration of 4 to 6 months, a 5-year survival rate of 2%, and a median survival time of 6 to 9 months.5 Although single-institution phase II studies and small phase III trials have shown that combination chemotherapy, or the addition of either tamoxifen or IFN to DTIC chemotherapy, has potential benefit, no regimen has yet proved superior to DTIC chemotherapy alone.6-13
Interleukin 2 (IL-2), a T-cell growth factor, was first identified in 1976,14 and isolation of the cDNA clone was described in 1983.15
Subsequently, recombinant IL-2 (rIL-2) was shown to have potent antitumor activity in a number of murine tumor models.16 Based on animal model data, a high-dose IL-2 regimen was developed in which IL-2 was administered by short intravenous infusion every 8 hours, with or without lymphokine-activated killer cells.17,18 High-dose bolus IL-2, as a single agent, received United States Food and Drug Administration approval in 1992 after demonstration of durable responses in patients with metastatic renal cell carcinoma.19 In this report, we describe findings from a recently updated 270-patient database of metastatic melanoma patients treated with the same high-dose IL-2 regimen between 1985 and 1993.”
Thursday, October 26, 2006
10/26/06 PM Got The Insurance Approval to Have the treatment down in Pittsburgh
PollyAnn just gave me the good news. I am going to Disney World to ride the famous Roller Coaster.
Heather Blair contacted me and we are on for the start of Interlukin 2 on Wednesday November 1. Warmups are at 9:00 am and the game begins at 3:00 pm. I got a bedside seat at 50 yard line. I can’t wait to see the cheerleaders.
Let the games begin!!!!!
Jimmy B.
Heather Blair contacted me and we are on for the start of Interlukin 2 on Wednesday November 1. Warmups are at 9:00 am and the game begins at 3:00 pm. I got a bedside seat at 50 yard line. I can’t wait to see the cheerleaders.
Let the games begin!!!!!
Jimmy B.
10/26/2006 Finals Week… Tests are completed. Yeh!!!!!!
I just finished my Nuclear (Thallium) Stress Test.
A nuclear stress test lets doctors see pictures of your heart while you are resting and shortly after you have exercised. The test can give information about the size of the heart's chambers, how well the heart is pumping blood, and whether the heart has any damaged or dead muscle. Nuclear stress tests can also give doctors information about your arteries and whether they might be narrowed or blocked because of coronary artery disease.
How does it work?
This test is almost the same as the exercise stress test, except doctors will give you a small amount of a radioactive substance just before the end of the exercise part of the test. This radioactive substance is not harmful to your body or your organs.The results of the nuclear stress test can show doctors if the heart is not working properly while you are resting, exercising, or both. If the test shows that blood flow is normal while you are resting but not normal while you are exercising, then doctors know that your blood flow to your heart is not adequate during times of stress. The heart normally pumps more blood during times of physical exertion. If the test results are not normal during both parts of the test (rest and exercise), part of your heart is permanently deprived of blood or is scarred. If doctors cannot see the radioactive substance in one part of your heart, it probably means that section of heart muscle has died, either because of a previous heart attack or because the coronary arteries supplying blood to that area of the heart are blocked.
The other two tests were CT Scan and the Pulmonary Function Tests. I gave you the results for the CT scan. I think I passed the Pulmonary Function Tests.
Pulmonary function tests are tests performed to make measurements of how your lungs and airways function. Results from pulmonary function tests enable your physician to evaluate your breathing, make diagnosis, recommend treatment and follow your progress.DLCO – Lung Diffusion Capacity TestingThis test measures how well gases (oxygen) move through the lung and into the bloodstream. I got an 88 out of a possible 100. Hey a b+ isn’t bad.
Waiting to get approval for IL-2 treatment
Jimmy B.
A nuclear stress test lets doctors see pictures of your heart while you are resting and shortly after you have exercised. The test can give information about the size of the heart's chambers, how well the heart is pumping blood, and whether the heart has any damaged or dead muscle. Nuclear stress tests can also give doctors information about your arteries and whether they might be narrowed or blocked because of coronary artery disease.
How does it work?
This test is almost the same as the exercise stress test, except doctors will give you a small amount of a radioactive substance just before the end of the exercise part of the test. This radioactive substance is not harmful to your body or your organs.The results of the nuclear stress test can show doctors if the heart is not working properly while you are resting, exercising, or both. If the test shows that blood flow is normal while you are resting but not normal while you are exercising, then doctors know that your blood flow to your heart is not adequate during times of stress. The heart normally pumps more blood during times of physical exertion. If the test results are not normal during both parts of the test (rest and exercise), part of your heart is permanently deprived of blood or is scarred. If doctors cannot see the radioactive substance in one part of your heart, it probably means that section of heart muscle has died, either because of a previous heart attack or because the coronary arteries supplying blood to that area of the heart are blocked.
The other two tests were CT Scan and the Pulmonary Function Tests. I gave you the results for the CT scan. I think I passed the Pulmonary Function Tests.
Pulmonary function tests are tests performed to make measurements of how your lungs and airways function. Results from pulmonary function tests enable your physician to evaluate your breathing, make diagnosis, recommend treatment and follow your progress.DLCO – Lung Diffusion Capacity TestingThis test measures how well gases (oxygen) move through the lung and into the bloodstream. I got an 88 out of a possible 100. Hey a b+ isn’t bad.
Waiting to get approval for IL-2 treatment
Jimmy B.
Wednesday, October 25, 2006
10/25/2006 Major Set Back!!!!!
Yesterday while at the Rochester Oncologist (Dr. Pandya) office we received bad news. The cancer is spreading in my lungs quite rapidly according to the CT scans. There are now over 40 nodules ranging from 15 mm down to < 5 mm. No wonder I been having shortness of breath. I thought it was my lack of exercise. Dr. Pandya gives my prognosis a poor rating. I guess I won’t be getting a raise this year.
I have started the long term disability process with disbelief. My fight is not over for a long shot. I just need to speed up my trials to find the right one. I will be contacting Dr. Kirkwood today to see where we stand on the Molecular Profiling route. I feel I am in the race of life and second place is not an option. I am going for the Gold.
Stay tune things may get very interesting.
Take care
Jimmy B.
I have started the long term disability process with disbelief. My fight is not over for a long shot. I just need to speed up my trials to find the right one. I will be contacting Dr. Kirkwood today to see where we stand on the Molecular Profiling route. I feel I am in the race of life and second place is not an option. I am going for the Gold.
Stay tune things may get very interesting.
Take care
Jimmy B.
Monday, October 23, 2006
10/23/2006 Going to be a busy week!!!!!
Well, I got all my tests scheduled for this week. Today I go for a CT scan at 11:00 am. They seem to know me by name there. That is not good is it? Tomorrow, I see my Rochester oncologist. This is just to keep them informed. Wednesday, I go to Rochester General for a pulmonary test. To check out my lungs to see if they are in good enough shape to proceed with the Interlukin 2 therapy. Finally, Thursday, will be the stress test to checkout my heart. This test will be induced by some drugs. I won’t be put on a tread mill. It will take about 4 hours.
That’s my week in review.
P.S. I will keep you posted if anything comes up.
Take care Jimmy B.
That’s my week in review.
P.S. I will keep you posted if anything comes up.
Take care Jimmy B.
Wednesday, October 18, 2006
This is the first step forward!!!!
An email from Arlet Alarcon to Kirkwood
Hello Dr. Kirkwood,
Please call me at your earliest convenience at any of the numbers below, so that we can discuss how to best help Mr. Jim Breitfeller.
Thank you,
Arlet
Arlet Alarcon, M.D.
Manager, Target Now/Horizon
Molecular Profiling Institute (MP)
445 N. 5th Street, 3rd Floor
Phoenix, AZ. 85004
(602) 358-8982 (direct)
(602) 358-8920 (fax)
(602) 909-7667 (cellular)
Hello Dr. Kirkwood,
Please call me at your earliest convenience at any of the numbers below, so that we can discuss how to best help Mr. Jim Breitfeller.
Thank you,
Arlet
Arlet Alarcon, M.D.
Manager, Target Now/Horizon
Molecular Profiling Institute (MP)
445 N. 5th Street, 3rd Floor
Phoenix, AZ. 85004
(602) 358-8982 (direct)
(602) 358-8920 (fax)
(602) 909-7667 (cellular)
Tuesday, October 17, 2006
10/17/2006 The Molecular Profiling Institute Called Yeh!!!!!!
I just received a call from Dr. Arlet Alarcon from the Molecular Profiling Institute. She is the clinical coordinator at the Institute. She gave me some background on what they do and how it would pertain to my situation.
Here the Deal:They would take a biopsy of my tumor and run a genomic sequence on it to determine the pathways that the tumor is using to nourish itself with the blood supply using the supercomputer. Once they determine the pathways, they try to figure out what chemotherapy or drugs would shut down the pathways choking off the blood supply to the tumors. The tumors would slowly die. Easier said than done.
It sounds like Science Fiction.
All I need is to get buy in from Dr. Kirkwood.
Luke Skywalker Here I come!!!!!!!!
Jimmy B. Signing off
Here the Deal:They would take a biopsy of my tumor and run a genomic sequence on it to determine the pathways that the tumor is using to nourish itself with the blood supply using the supercomputer. Once they determine the pathways, they try to figure out what chemotherapy or drugs would shut down the pathways choking off the blood supply to the tumors. The tumors would slowly die. Easier said than done.
It sounds like Science Fiction.
All I need is to get buy in from Dr. Kirkwood.
Luke Skywalker Here I come!!!!!!!!
Jimmy B. Signing off
10/17/06 Need a cocktail treatment for malignant melanoma using a supercomputer.
There was a program on the CBS Evening News October 13 2006 with Katie Couric using supercomputers to analyze blood and tumor tissues. It would analyze the genomic makeup of the samples and then calculate what the best probable therapy treatment for that patient. The only problem was, it was set up for prostate cancer. The Researcher’s Name was Dr. David B, Agus.
So I emailed him:
Dr. Agus,I am presently a patient of Dr. John Kirkwood of the Hillman Cancer Center in Pittsburgh. I am in the battle of my life trying to overcome melanoma. I am 48 yrs. old just in the prime of my life. I have tried Interferon, Dicarbazine and CTLA-4 monoclonal antibodies therapies without any success. I saw your story on the CBS Evening News and was hoping that if I submitted my blood sample or donate a tumor, maybe we could get a handle on the treatment protocol for my cancer. Any Help would be greatly appreciated.
Here is Dr. Agus’s response:
JimJohn is an excellent doctor and I am happy to help in any way I can. Presently we do not have melanoma protocols in the database to do correlations. There is a group out of TGEN called MPI (molecular profiling institute) which does a Target now analysis:
http://www.molecularprofiling.com/products/target.cfm
the group is run by dan von hoff and is excellent. The data from this analysis can be used to help ‘guide’ therapeutic decisions.
Use my name if you would like when you call them.
Good luck
David B. Agus, M.D.Director,
Spielberg Family Center for Applied ProteomicsResearch Director,
Cedars-Sinai Prostate Cancer Center
8631 West Third Street, Suite 215ELos Angeles, CA 90048
Tel (310) 423-7600
Fax (310) 423-1998
Here is an excerpt of Molecularprofiling:
"The Molecular Profiling Institute's Target Now research program provides advanced tumor analysis for cancer patients whose disease has progressed despite having received first and second-line standard therapies. This unique analysis has resulted in some positive individual outcomes that are presently being validated in a clinical study.
Target Now offers advanced molecular tumor analysis and provides potential therapeutic options to cancer patients for whom several standard therapies have failed. These are patients who need a targeted approach to treat their cancer – now
Based on the molecular profile of a patient's tumor, our program generates potential treatment options that would likely otherwise not be considered. Target Now is going through a prospective clinical trial prior to wider availability. Cancer patients who have clinically progressed despite having received first and second-line standard treatments are now able to access an opportunity - not offered anywhere else in the country - to have their cancer sampled, profiled and assessed to determine if one or more drug targets may exist in their tumor tissue.
The physician report for Target Now patients is generated by our proprietary Personalized Medicine Expert System (PerMedEx). PerMedEx and the associated report assists the physician to more clearly link drug targets to the molecular profile of a patient's tumor and offers the associated references and abstracts to the supporting medical literature."
So I sent this information to Melissa in Pittsburgh and I am waiting to hear their response.
That is it for now.
P.S. You can't say I am not giving it the "Old College Try"
Jimmy B.
So I emailed him:
Dr. Agus,I am presently a patient of Dr. John Kirkwood of the Hillman Cancer Center in Pittsburgh. I am in the battle of my life trying to overcome melanoma. I am 48 yrs. old just in the prime of my life. I have tried Interferon, Dicarbazine and CTLA-4 monoclonal antibodies therapies without any success. I saw your story on the CBS Evening News and was hoping that if I submitted my blood sample or donate a tumor, maybe we could get a handle on the treatment protocol for my cancer. Any Help would be greatly appreciated.
Here is Dr. Agus’s response:
JimJohn is an excellent doctor and I am happy to help in any way I can. Presently we do not have melanoma protocols in the database to do correlations. There is a group out of TGEN called MPI (molecular profiling institute) which does a Target now analysis:
http://www.molecularprofiling.com/products/target.cfm
the group is run by dan von hoff and is excellent. The data from this analysis can be used to help ‘guide’ therapeutic decisions.
Use my name if you would like when you call them.
Good luck
David B. Agus, M.D.Director,
Spielberg Family Center for Applied ProteomicsResearch Director,
Cedars-Sinai Prostate Cancer Center
8631 West Third Street, Suite 215ELos Angeles, CA 90048
Tel (310) 423-7600
Fax (310) 423-1998
Here is an excerpt of Molecularprofiling:
"The Molecular Profiling Institute's Target Now research program provides advanced tumor analysis for cancer patients whose disease has progressed despite having received first and second-line standard therapies. This unique analysis has resulted in some positive individual outcomes that are presently being validated in a clinical study.
Target Now offers advanced molecular tumor analysis and provides potential therapeutic options to cancer patients for whom several standard therapies have failed. These are patients who need a targeted approach to treat their cancer – now
Based on the molecular profile of a patient's tumor, our program generates potential treatment options that would likely otherwise not be considered. Target Now is going through a prospective clinical trial prior to wider availability. Cancer patients who have clinically progressed despite having received first and second-line standard treatments are now able to access an opportunity - not offered anywhere else in the country - to have their cancer sampled, profiled and assessed to determine if one or more drug targets may exist in their tumor tissue.
The physician report for Target Now patients is generated by our proprietary Personalized Medicine Expert System (PerMedEx). PerMedEx and the associated report assists the physician to more clearly link drug targets to the molecular profile of a patient's tumor and offers the associated references and abstracts to the supporting medical literature."
So I sent this information to Melissa in Pittsburgh and I am waiting to hear their response.
That is it for now.
P.S. You can't say I am not giving it the "Old College Try"
Jimmy B.
Thursday, October 12, 2006
Results of early PROLEUKIN® IL-2 Clinical Trials
Metastatic MelanomaYear received FDA Approval 1998Number of Patients 270 patientsNumber of Trials 8Response In 16% of the patients, tumors shrank or disappeared as a result of PROLEUKIN® IL-2 therapy.
In 6% of the patients, the tumors disappeared completely.Results From these trials, it was determined that a patient whose tumors completely disappeared from the treatment remained cancer-free for a median of 4.9 years.
In 6% of the patients, the tumors disappeared completely.Results From these trials, it was determined that a patient whose tumors completely disappeared from the treatment remained cancer-free for a median of 4.9 years.
10/12/2006 Back to square one !!!
A couple of days ago, Dee noticed two new growths on my back. I was hoping for the best. Anyway, we got confirmation from the Hillman Center that it is 2 new tumors growing. This really stinks. I think it is time to take out the “Weed be Gone”. This is not what I was hoping to hear.
My batting is like the the NY Yankees, and they missed the playoffs. But there is one good thing, I saved money on car insurance by switch to Gieco. Only Kidding
So, it is on to the next trial. I am not sure what is going to be, but they mention Interlukin 2.
I am NOTTTTTTT throwing in the towel.
Jimmy B.
My batting is like the the NY Yankees, and they missed the playoffs. But there is one good thing, I saved money on car insurance by switch to Gieco. Only Kidding
So, it is on to the next trial. I am not sure what is going to be, but they mention Interlukin 2.
I am NOTTTTTTT throwing in the towel.
Jimmy B.
Tuesday, October 10, 2006
On the road again!!!!!
Back to Pittsburgh.I still have fatigue but I am managing it. What really bothers me is my right arm where they removed the lymph nodes. I can't get the swelling down which in turn puts pressure on my nerves.I have to baby it to try to bring down the swelling. Some days it feel like it is caught in a vise. I am going ask if they can drain the excess fluid if possible. I should be back on in a day so.
"All Quiet on the Western Front"
Jimmy B.