We were very happy to hear that the two samples both contained differentiated cells. However, the samples contained cells that are not differentiated as well, meaning some of the cells are still active and could possibly cause the tumor to continue to grow.
The tumor markers in her urine have been decreasing over the past few months but a minor rise was detected last week. It’s not clear to the doctors whether this is significant or not. Tomorrow we will bring in another urine sample and if the tumor markers are still the same or any higher, the plan will be to start a new chemo for 2 cycles. If by some chance that the tumor markers are decreasing, the plan will be to start a drug called Isotretinoin (cis-retinoic acid), which is also used for acne treatment. In Reba’s case, this would drive the cells to further differentiate.
If chemo is needed, it will most likely start July 25. The two drugs would be Irinotecan and Vincristine. If this is the next step in Reba’s treatment, the two cycles would be followed by an MRI and then the Isotretinoin to drive cell differentiation.