Finally...

Yesterday, after seven weeks of waiting, I finally heard from Dana-Farber that my tumor tissue did not show evidence of the C-KIT mutation needed to participate in the Gleevec trial. The news was anti-climactic, because I had a CT scan on Thursday which showed continued tumor growths and my doctor and I felt more aggressive treatment was needed now.

The bottom line is that I will be starting on Temodar (temozolomide) on Monday. Temodar is an alkylating agent most active in the resting phase of a cell, but is non-cycle non-specific. It is classed as a Hydrazine or Triazine, which also include Altretamine, Procarbazine, and Dacarbazine. Like Dacarbazine, Temodar is a "pro-drug," which needs to be transformed to its active state by the patient's metabolism.

After nearly two months of waiting, it's pretty cool how fast things moved once the decision was made. A lab tech appeared and took blood samples for analysis, followed by a nurse who gave me a flu shot, then the nurse navigator took me down to the person who handles chemo prescriptions, who had already figured out how this was going to be paid for. All she needed to know was when I wanted to start. If I had said, "today,' she would have had the scrips (Temodar, plus two anti-nausea drugs) couriered over from the provider. Since I opted for Monday, the drugs will be sent to me at home.

Treatment consists of three 100 mg capsules taken two hours after my last meal each day for five consecutive days, preceded by a Zofran tab (anti-nausea) thirty minutes before the Temodar. There is also another anti-nausea drug to be taken every six-hours. (Guess what's a major side effect of Temodar). The five-day pill-taking cycle is followed by 23 days of doing nothing, other than recuperating from any side effects. I've been told I will be very fatigued on days 6 and 7.

Other side effects include the possibility of hair thinning, anorexia, headache, constipation, and myelosuppression (low blood counts). The last could lead to anemia and a weakened immune system, hence, the flu vaccination.

The plan is to do two 28-day cycles of Temodar, then, depending upon the outcome, decide what to do next. Stay tuned for progress reports.