Am I On the Right Track? Encouraging Good News on Nivolumab (Opdivo)

Ailments anyone? 1900-1930 pharmacy in Chokoloskee, FL (Everglades); Photo: BJ Gabrielsen

In December 2016, when I first embarked on my latest course of prostate cancer treatments, it seemed logical to me to treat the cancer first by stimulating my immune system; therefore, Provenge® (sipuleucel-T) was my first choice. That course of three treatments were administered quite readily. Immediately after receiving Provenge®, I was unexpectedly made aware (from a former NCI colleague as I may have written in an earlier blog), of the National Cancer Institute (NCI) clinical trial in which I am currently participating wherein I receive the vaccine Prostvac and the monoclonal antibody therapy nivolumab (Opdivo®). Nivolumab, an immune checkpoint inhibitor, is already approved for the treatment of several other cancers, including melanoma, bladder cancer, head and neck cancer, and Hodgkin’s lymphoma. Laboratory studies have shown that immune cells found within tumors often overexpress (over-produce) the protein PD-1 which is targeted by nivolumab, and which prevents those immune cells from recognizing and attacking the cancer cells. (For more information on how nivolumab works, see the May 15th, 2017 post.) So at this point, I am fully engaged in the NCI biweekly trial.

As a Christian, I continuously seek God’s plan for all aspects of my  life certainly including my now 22-year old battle with prostate cancer. God and Jesus (in that still small voice) have reinforced the message to me on several occasions that they are very much involved in my disease and treatment which I have previously described on this website. But I am human; doubt and lack of faith in God’s Word and His promises periodically creep in. I generally start each morning by spending twenty minutes or so reading Bible passages as cited in 2-3 daily devotional books. A few days ago, as I was quietly meditating and praying, I asked God “am I really on the right track here with this trial or am I just deluding myself? Is this really part of Your plan for me?” Many clinical trials don’t work out as positively as researchers had hoped they would. In many trials, only a small subset of patients experience positive results. I thought “could I be engaging in wishful-thinking, that this trial would be overall successful and that Prostvac and Opdivo® would retard my cancer specifically? After all, I had been involved in biomedical research at NCI for over fifteen years before retirement, therefore this trial has an excellent chance of success right? Is this really where you want me at this time, Lord?” From my heart, I asked God to show me if I am following the right therapeutic path or not.

After pleading my case to God and embarking on the day, I immediately checked my e mails and, there again was a totally unexpected article from the National Cancer Institute. The October 23rd NCI article stated that “on September 22, the Food and Drug Administration (FDA) granted accelerated approval to the immunotherapy drug nivolumab (Opdivo®) for some patients with advanced liver cancer (hepatocellular carcinoma).” This is in addition to the cancer types in which nivolumab had already produced some positive responses and in the current trial, it is being paired with a specific prostate cancer vaccine. The message I perceived was that God was telling me again to stay the course, “you are where I want you to be.” Do I believe I will be cured? Physicians say no, but God is certainly able to heal me if it is His will. Whatever the case, I will be content and fully trust in His overall game-plan. I have nowhere else to go for such divine wisdom, love and care. Periodically, as I have needed and asked for, God has given me these confirmatory signposts as I travel this journey. I believe this was another such marker. If you are not sure if you have a personal relationship with God in your life, see the following section. (To be continued).

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