More data, more or less

Just completed Trabectedin Round #11 yesterday. Feeling really good, but of course the tiredness and nausea usually doesn’t hit me until Sunday evening. However, since lowering my dosage I’ve only puked once over the last two cycles (instead of five or six times each cycle) so I’m optimistic that we’ve settled on a winning treatment regimen.

I’ve now processed the data from the last two CT scans and will try to present it in a more simplified manner than previous attempts. The clinical trial protocol uses what’s known as “RECIST” criteria which in essence tracks the largest of the two major cross-sectional linear dimensions for each tumor (the longitudinal dimension is not recorded because it is considered the least accurate measurement). In my situation, they are tracking five tumors (abdominal, gluteal, spinae, right lung, and left lung). And “progress” is compared against the dimensions that were recorded at the outset of the treatment course, not against the point at which the tumors were at their maximum size.

Following is a graph depicting the RECIST results (i.e., maximum lineal cross-section dimension for the tracked tumors). The bold black line represents the average value. The vertical dashed red lines represent Trabectedin treatments at the higher dosage, while the vertical dashed blue lines represent the 20% reduced dosage. For those of you that do not like analyzing graphs, the maximum lineal cross-sectional dimension for the average tumor has shrunk by 28% since the sea squirts were set loose.


Because lineal dimensions do not tell the full story in terms of tumor volume, I’ve also compiled the data in volumetric terms. For this analysis, I’ve used the average of the cross-sectional dimensions for each tumor and assumed that the change in longitudinal dimension has approximated the change in cross-sectional dimensions. The result of this analysis is depicted below. Again, for the graphically-challenged among you, the estimated volumetric data indicates an average shrinkage of 76%. (The largest tumor, the one in my abdomen, has shrunk approximately 46%.)


In summary, I’m thrilled with the dimensional results and how well I am feeling these days. And I’m very grateful that during the 1950s and 1960s, the National Cancer Institute carried out a wide ranging program of screening plant and marine organism material. Extract from the sea squirt was found to have anticancer activity in 1969. Harvard chemist E. J. Corey developed a synthetic method of preparation in 1996 and it was first dosed in humans that same year. Although it is also in phase II trials for ovarian, prostate, breast and pediatric cancers, it is my understanding that it has proven most effective against myxoid liposarcoma, that rare beast that first hitched a ride with me seventeen years ago.

Onward and upward.