KRAS, ALK, EGFR … WTF?

Since genetic mutations can often occur with adenocarcinoma, Chip’s test results were sent to The Mayo Clinic for further analysis.  The oncologists had both laid out similar treatment plans for us based on various scenarios–intravenous chemo if there were no mutations at all, approved drugs if it were this particular mutation, what clinical trial was available if it were this mutation and if it happened to be the KRAS mutation, well, that was just not going to be good at all.  At this time, Chip is not eligible for radiation or surgery, because the cancerous tumors are widespread throughout his abdomen.

After several long days, the results finally came back, and it turns out Chip has a genetic cell mutation which affects 2% of adenocarcinoma victims called ALK translocation. It’s all relative these days, but we were ecstatic with this news, because both oncologists had said there was an approved and effective drug called Crizotinib or Xalkori to treat this particular mutation. 2%.  I always knew Chip was special.

We were desperate to start treatment, so we were elated when Dr. B, the oncologist at Johns Hopkins University, e-mailed us over the weekend, the day of Joe’s 3rd birthday party, indicating how great this news of the ALK mutation was. She was going ahead and submitting the prescription to the pharmacist so the authorization process with our insurance company could begin, and asked us to come in to see her in a couple of days for blood work and an EKG and to pick up the prescription.  Hallelujah!  The ball was once again in motion.  In the meantime, the tumor in Chip’s eye was starting to cause him significant pain and he had undergone his first of what will be monthly bone strengthening infusions, which ended up making him quite ill for a couple of days.

It’s game on now, cancer!

On Thursday, November 15th, after spending another full day at Hopkins, Chip popped his first pill at home that evening.  Just for good measure, we decided to celebrate by washing it down with a shot of Pappy Van Winkle’s.  Within hours, he was throwing up, and it was another long, long night in the Kennett household, but Chip is slowly adjusting to the medication. The pain in his eye has fully subsided, so we are hopeful this means his body is responding to the treatment.

Xalkori is considered to be a “smart” drug. Intravenous chemo poisons all cells–healthy and unhealthy ones. Smart drugs only target the cancerous cells.  They basically open the receptors or “doors” to the diseased cells, and allow the poison to travel in and eat the cancer.

Chip takes his medication at 8:30 AM and PM each day.  Every single time, I visualize those little doors opening up, the poison traveling in and EATing the cancer.  Eating it all up.  Isn’t that just the best visual??

– Sheila