Avastin, Ye Swabs!!!

It was close to noon her time when Lila called me today, saying she'd just awoken, after not sleeping well over-night, or really over the last two nights. As we rang off, I said something about a sort of sociological side-effect of the amazingly expensive nature of the treatments, and she wanted me to remind her of it next time we talk. I had thought that might yet be today again, but now likely not. Tomorrow, then.

Lila had a busy day ahead, she said as she put her wig-hat on her head, and adjusted her high-heel sneekers to cover some ground. Culminating event of the day was/is a check-up by the surgeon who put that spiffy, tricksy docking-port in her chest, in preparation for the second round of chemo, tomorrow. There's all kinds of little tools that come along with the port-thingy. Everybody's gotta be careful with it, cuz 1) it's a pretty new deal and not all medical/surgical/theraputic personnel are familiar with 'em yet, and 2) because the thing, un- or ill-attended, is potentially a Disneyland ride for opportunistic infections. It's a small world, after all...

Before the valve-check, she was going to go into school to meet with her ex-boss, and interview some candidates to take over her classes for the next year, while they conduct a national search. I think she was very flattered to be invited. She's a wizard-good teacher. We usta talk pedagogy for hours...

Then she was going to go personally investigate the availability and quality of the wigs made available to less-well-off cancer treatment patients locally through the Cancer Society. I await her report on this.

The report today is briefer than normal, but our chat was brief, too. There has been a development in the clinical pharmacology of one of the chemo drugs that Lila's being given--actually, to be literal, she is being given some, but is taking this one, after having had to sign a release. The drug is Avastin. (Sounds like a line in a pirate movie: Avastin, ye scurvy tumors!!!)

In a story in the Sunday NYTimes reported there were rising doubts about the utility of the drug in its prescribed modalities, since it didn't seem to contribute much to prolonging life, which is what they're ALWAYS doing. The thing about it is, that Avastin mostly gets used in what are called "rare" --or sometimes "orphan"-- diseases for which there aren't a whole lot of other 'treatment options.' Another thing is, the stuff is KING-HELL expensive, enough for a year's normal treatment would set a patient close to $100K.

Now here's what else is kind of interesting. The company that makes the drug, Genentech, is lobbying the FDA to get Avastin approved for a lot longer list of diagnoses than the several for which it is now approved, but in which its efficacy is in fact in doubt. This is the season during which the out-going President turns loose the elves in their Departments to shower largesse/lagniappe upon their loyal supporters in the regulation community. So it will be interesting to see in which direction Avastin's ship sails.