Bob’s Immunotherapy Story

On March 17th, St Patrick’s day 2014, my wife and I were sitting at Memorial Sloan-Kettering Cancer Center (MSKCC) in an examination room waiting for my new Oncologist, Dr. Jonathan Rosenberg to give us the news. Upon his arrival I could tell by looking at his face, it was not good. He confirmed that I had stage 4 Urothelial Carcinoma. Bladder cancer had metastasized to my liver with innumerable tumors. There were approximately 40 in my liver at that time. Since I had worked in the pharmaceutical industry for over 27 years, I understood the impact of this diagnosis. I knew my time on this planet was extremely limited. I was unsure if I would reach my 49th birthday in mid-July. The next ten minutes or so were a blur. We discussed various options and I could tell by the doctor’s tone we had to move quickly. It was decided that I would be put on Gemcitabine & Cisplatin immediately. He also suggested, and I agreed, to participate in an Avastin drug clinical trial which might also help to reduce the amount of tumors and size of them.

A week later I was to start an 18-week regimen, and I was pretty weak weighing only 151 lbs. During the next few months, my CT scans showed drastic improvement as my tumors started to shrink and disappear. I had continued improvement for the next ten months as approximately 70% reduction of cancer was seen.

By the way, I did make it to my 49th birthday!! Then, in January 2015, my tumors started to get larger again. A few new ones appeared. At that point, we knew that that cancer had returned. Once again I was up against probably a few months left. We had used the “big guns” to treat it, and not much more could be done.

It was at that point my physician, and I discussed another trial (the second one for me) using a new immunotherapy drug call Nivolumab (Opdivo) that had shown some improvement in melanoma patients and seemed to work about 30% of the time. Although I had liver metastasis which was even harder to treat, my doctor and I discussed that even a 10% chance would be better than not trying.

Six weeks after treatment, my scan showed that my tumors were still getting larger and a couple of new ones appeared. Things didn’t look good. Dr. Rosenberg shared with me that sometimes this occurred and that we should stay the course as they had seen delayed responses in some patients. Six weeks later the next scan results were dramatically improved, the tumors started to shrink and disappear!! Today February 2017, I can report that I did have a 50th and 51st birthday and starting to think about many more to come!! If it weren’t for Dr. Rosenberg, Sloan Kettering, two additional clinical trials, my faith and the support of my family, I would not be writing about this amazing journey!!