In our last thrilling installment, about seven weeks ago, L’s oncologist had, rather peremptorily, we thought, cut her off from the “ENHERTU” regimen because she judged that the treatment’s efficacy had fallen off. We then enrolled in an LA-based clinical trial which has taken us on roundtrips to the Southland half a dozen times since then. On our last round of tests and consultations the attending physician announced that the “sponsor”—the pharma outfit overseeing the tests—was terminating her participation, because her “cancer antigen” numbers had spiked to levels unseen in two years, and new tumors have sprouted and thrived in her liver. These weren’t the results the shareholders were looking for. (That’s probably unfair. The tests will have yielded data sufficient to indicate that the treatment was not appropriate for her specific flavor of cancer, although see below.)

This morning we consulted with kindly Dr. Bookman in nearby Walnut Creek. Doc B is not given to dispensing false hopes, but he’s a damn sight more forthcoming than the spousette’s Oakland oncologist. He told us that as he reads the numbers and the scans, the recently-aborted trial cocktail was not merely inefficacious, but appears actually to have fed the disease, something not unprecedented in these clinical trials (why, we wondered, had no one mentioned this before we enrolled? Forget it, Jake, it’s Cancertown).

In effect, given that the clinical trial has done no good and may even have done some harm, the cancer has been romping around untreated and unimpeded since mid-spring. The good news (such as it is) is that B thinks a second round of ENHERTU could well knock the beast back on its heels again for a few more months, presumably with a concomitant return to the vigor and energy the patient enjoyed during the first quarter of the year.

We are cautioned that, as the Oakland oncologist drily informed us on our first consultation, “there are no good outcomes here.” Doc B asked us “What is it you’re looking for in terms of results?” Lina: “Well, a cure.” B: “Sorry, not going to happen.” L: “Yeah, I sort of figured. Worth a try, though.”

So it appears that the Oakland oncologist will reluctantly consent to a renewal of the ENHERTU infusions, beginning on the morrow. Doc B predicts that during the interval of unimpeded growth the cancer has likely let down its guard. We can only hope.

cordially,