Of Guinea Pigs, Romance and Financial Advice

The Providence Cancer Tower in Portland

We had a busy two weeks. During the chemo-vacation, we were on two-weekly oncology visits because cancer can grow fast and unexpectedly. And so it did.  Our oncologist worried about the chest pain that seemed to be getting worse and the pain in my back and butt that did not go away. She went into full panic mode and when she does, things happen. A CT scan and MRI was scheduled for the next day and we came back two days later to discuss the result. The news was not exactly what we wanted to hear: the bone cancer had spread to the right hip and the damage in the lung had enlarged and is now diagnosed as cancer as well.  That was a bit of a bummer, but amazingly there are still a few choices left: we could switch to a pill based cancer drug called Tarceva which can delay cancer growth and add some time to the good life we are having without too many side effects. Alternatively we could participate in a clinical trial of an immunotherapy drug that is in development.

Our Oncologist

I had read about immunotherapy drugs and knew that every major pharmaceutical company is racing to get these kinds of drugs approved. We are fortunate to have an oncologist who is a leading scientist in the field of Lung Cancer Research and supervises one of the three test legs for Bristol Myers Squibb. She thought I could qualify for the clinical trial and we started the paperwork immediately. The test protocol requires a number of tests that had to be completed before acceptance and that included another MRI in the afternoon; a biopsy of lung tissue on Monday; a CT scan and a bone scan (that requires an infusion of radioactive material – our toilet now glows in the dark) as well as an X ray on Tuesday and too many blood samples to remember. On Wednesday we went to the hospital to check if any of the tests had disqualified my participation, and when that was not the case, the first infusion started right then and there. 7 hours later we walked out of the hospital as an official Guinea Pig with the new drugs infused and hopefully they are now killing some cancer cells.

Portland and Mt Hood

Hilton Portland

In the middle of all that medical ado, romance was flourishing. On a beautiful Saturday, March 22, Bonnie and I celebrated 45 years of marital bliss with a romantic date in Portland. The afternoon started with an exquisite lunch in restaurant Andina, according to Urban Spoon one of the top 5 restaurants in the city. For the Philadelphians: this is the Peruvian equivalent of restaurant Amada: it cannot get any better than that. This was followed by a white wine tasting in the Hilton, and a classical concert in the Arlene Schnitzer Center. Bonnie was a little disappointed she was not called on stage this time but other than that the concert was perfect. Afterwards there was, of course, a tasting of the regional red wines and snacks before stumbling into our room at the Hilton.

Ferry Street, Eugene Oregon.
Bert Versteege, Eva Ouwehand, Phocas Savenije,
Larry Lissman, Lydia Simoneau and the
gorgeous bride

45 years of marital bliss: March 22, 1969 and March 22, 2014

About the new cancer drugs:
Immunotherapy is probably the future of cancer treatment. Whereas traditional cancer drugs target and kill all kinds of fast growing cancer cells (and hair is one of these fast growing cells, that is why you lose it), immunotherapy enables the patient’s own immune system to selectively kill cancer cells.  The system would always do that, were it not for the fact that cancer cells bind certain proteins, which make them appear as normal cells. Pharmaceutical research is now focused on removing the proteins from cancer cells so that the immune system’s T cells can - chomp, chomp - eat the cancer cells. It was first discovered in Melanoma (the deadly form of skin cancer) treatment and Bristol Myers Squibb has an immunotherapy drug on the market that shows a spectacular improvement in 3 year Melanoma survival rate. At $120,000 for 4 injections there better be some improvement. Lung Cancer is the most common form of cancer (over 200,000 cases in the US every year) and that is where the real money is. It is no surprise that the immunotherapy concept is now being applied to lung cancer and Bristol Meyer Squibb (BMY), Merck (MRK) and Roche are apparently the front runners. The Phase 1 test in which I participate is a combination of two drugs that are given intravenously every two weeks (Nivolumab) and four weeks (Lirilumab) to remove 2 different proteins from cancer cells (PDL1 and KIR). The Wall Street Journal estimates the price of this drug, when approved, to be $ 220,000 per year and that times 200,000 new cases per year translates to $ 40 billion in sales. Ka-Ching..! With the many uninsured people in the US, it will not go that fast, but according to the WSJ, Bristol Meyer Squibb could add another 6 billion sales in three years, which is a significant increase compared to the 30 Billion Sales they have now.  In my hospital, 8 patients were already in the clinical trial when I started. The wife of one of the patients wrote in a web forum that her husband had a 41% reduction in tumor size after 8 weeks. Wow.  I don’t know about the other 7 and the medical staff will not discuss patients. However, as long as you see new installments of this blog, BMY shares look like a winner. If the blog suddenly stops, it may be time to sell.

Since this is a public blog, the above is not investment advice, we do not currently own BMY and you better do your own DD.