Tag: ABVD

My Name Is CC, and I Am a Cancer Survivor

“Hello, my name is CC, and I am a cancer survivor.”

I never thought that those words would sit together in the same sentence, let alone with a great deal of comfort and elbow room. I never thought that the word “cancer” would be applied to me at all. And I never thought that I would carry the words with me still, after it was all over. You see, I was hoping I would be able to tuck cancer away, someplace small and sacred, and be able to forget that I was ever that sick, forget that I ever did all that chemo, and forget that my life was forever changed.

But that’s not what happened. That’s not the story.

I was young. I was active. I was social. I was ambitious in my career and excited about the future. I was a “healthy” and “normal” 29-year-old when I was diagnosed with stage IV Hodgkin lymphoma in the sleeting February of 2016. After getting totally emotionally sidelined by the diagnosis, I completed six rounds (12 infusions total) of ABVD chemotherapy. That’s a total of 36 hours in the infusion center’s bustling waiting room, 72 hours in the chemo chair, watching 259,200 drips trickle down from the chemo bag into the big blue vein in my arm. That’s 12 lightly toasted bagels from the café downstairs, an infinite number of hand holds and arm rubs from my mother, and countless times the floor dropped out from beneath me to swirl with the walls.

WebsterSisters
With my sister, Ashley, in July 2016, before my final treatment.

When I tumbled out the other side into remission that sweaty August, I tried to pick up my life and career where I had left it, but it just wasn’t the same. Something was missing. It was like my doctor had sent me home with a stick shift when I only knew how to drive an automatic. Everything I had built for myself had seemed to disappear, sinking between my fingers. All of my dreams and my excitement for the future fell in a heap on the floor, having lost their glitter and gleam. I had to rebuild by finding and following my sense of joy, passion, peace and purpose.

My observations and perspectives surrounding my experience with cancer may ring true to anyone who has sat in that chemo chair, or who has shown up to a cocktail party with a fresh buzz cut. But more than a cancer story, my story is one of facing challenge and surviving. It is a story about the power of the physical body and the emotional self. It is a story about love. And most of all, it is story of hope, with a little bit of humor.

I want to tell my story in this blog post and in the next ones to come, with this community specifically, because this is where I came for help, too. Stay tuned. I can’t wait to share my story with you.

CCWebster_PhotoCC Webster is a recent survivor, patient of Weill Cornell Medicine/NewYork-Presbyterian (WCM/NYP), and author of So That Happened, a memoir that offers a candid reflection on her experience with cancer as a young adult. Diagnosed with Hodgkin lymphoma at the age of 29, CC completed treatment under Dr. John Leonard and his team at WCM/NYP’s Lymphoma Program. Now in remission, she is sharing her story, perspective, and insights in hopes of raising awareness of the disease and helping others through the battle – always with a little bit of humor. Her book is available on Amazon, Barnes & Noble, Goodreads, and through her site and publishing platform Webster Works. CC lives with her husband, Matt, in New York City.

Novel Therapy Approved for Previously Untreated Hodgkin Lymphoma Patients

The United States Food and Drug Administration (FDA) recently approved brentuximab vedotin in combination with chemotherapy as a first-line treatment for people with advanced-stage classical Hodgkin lymphoma.

Also known as Adcetris, brentuximab vedotin is an antibody drug conjugate that targets the CD30 protein present on lymphoma cells and delivers a toxin designed to promote cancer cell death. The drug has been previously approved to treat systemic anaplastic large cell lymphoma (ALCL) and Hodgkin lymphoma that has returned after prior therapy.

The FDA’s approval follows the encouraging results of the phase III ECHELON-1 clinical trial, presented at the 2017 American Society of Hematology (ASH) Meeting and Exposition and published in the New England Journal of Medicine. The trial, which was open at Weill Cornell Medicine and NewYork-Presbyterian Hospital, compared standard therapy with adriamycin, bleomycin, vinblastine and dacarbazine (ABVD) versus adriamycin, vinblastine and dacarbazine plus brentuximab vedotin (A+AVD).

Of the 1,300+ enrolled patients, those receiving A+AVD were demonstrated to be 23 percent less likely to experience disease progression, a need for additional therapy, or death, as compared to the cohort receiving the standard of care therapy.

Weill Cornell Medicine
Dr. Peter Martin

“ABVD has been the standard therapy for a couple decades because it works really well, but it’s great to have new treatments available for people with Hodgkin lymphoma,” said Peter Martin, Chief of the Lymphoma Program. “I’m proud that we were able to offer this treatment at Weill Cornell a long time ago through the ECHELON-1 trial. Like any treatment, the A+AVD combination may not be right for everyone and requires consideration of side effects, like infection risk and neuropathy. Decisions between patients and physicians regarding the best treatment should follow an open discussion of the evidence.”

 

Dr. Lisa Roth Highlights Differences in Treatment Approaches for Pediatric Vs. Adult Hodgkin Lymphoma

SOSS_Roth_FurmanAt OncLive’s State of the Science Summit on Hematologic Malignancies, Dr. Lisa Roth, head of the Adolescent and Young Adult (AYA) Lymphoma Program at Weill Cornell Medicine and NewYork-Presbyterian, outlined some of the differences in treatment approaches between pediatric and adult patients with Hodgkin lymphoma (HL), a cancer commonly diagnosed in young adults in their twenties.

According to the National Institutes of Health (NIH), patients between 15 and 39 years of age are considered part of the AYA population.

“A patient in this age range can walk into a pediatric oncologist’s office or a medical oncologist’s office and receive vastly different treatment for the exact same diagnosis,” said Dr. Roth, highlighting the medical landscape’s current lack of and need for research in order to understand how to optimize care for AYA patients.

To compare and contrast the approaches, Dr. Roth broke down the components of the pediatric and adult treatment regimens for a standard case of Hodgkin lymphoma.

A HL patient treated under the pediatric regimen would typically receive four cycles of the chemotherapy drug combination doxorubicin hydrochloride, bleomycin, vincristine sulfate, etoposide phosphate, prednisone, and cyclophosphamide (ABVE-PC) over 12 weeks, as compared to the adult regimen of six cycles of chemotherapy drug combination doxorubicin hydrochloride, bleomycin, vinblastine sulfate, and dacarbazine (ABVD) over 24 weeks. About half of pediatric patients would receive radiation following ABVE-PC while very few adult patients would receive the same following ABVD.

Compared to its adult counterpart, the pediatric regimen has lower cumulative exposure to anthracycline, a drug class associated with cardiac toxicity that includes doxorubicin, as well as a lower dosage of bleomycin, a drug associated with pulmonary toxicity.

On the other hand, the adult ABVD regimen does not contain drugs etoposide or cyclophosphamide, both of which are associated with risk of secondary malignancies and infertility.

Dr. Roth explained that outcome improvements in adolescent and young adult patients are lagging behind those in both pediatric and adult populations – a disparity partially connected to the deficit of clinical and translational research focusing specifically on this age group. Other contributing factors may relate to differences in tumor biology in the AYA group that doctors do not yet fully understand, as well as the group’s tendency to delay physician consultation and to have limited healthcare access due to being under or uninsured.

Because the AYA population has such unique needs, they require a multidisciplinary team to guide them through each stage of their treatment process. The Weill Cornell Medicine/NewYork-Presbyterian Adolescent and Young Adult Lymphoma Program is composed of pediatric and medical oncologists, radiation oncologists, bone marrow transplant experts, fertility preservation specialists, and psychologists and social workers. The team also includes physicians who specialize in survivorship to allow for seamless care from treatment to beyond, which is specifically relevant for patients of this age range who are very likely to have many years of life to look forward to once cured of their disease.

WCM’s AYA Lymphoma Program is working hard to expand pediatric patients’ access to upcoming clinical trials and to develop trials specific to the AYA population.

For more from Dr. Roth on the intricacies of treating the AYA population, watch this video courtesy of OncLive:

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