CONTINUED response -> TREATMENT ADJUSTMENT

On the day I departed to Chicago to attend my first annual ASCO meeting as a patient advocate (see previous post), I drew blood for a second circulating tumor DNA test.  Once again, no evidence of molecular, residual disease was detected.

After 6 cycles with both pharmaceuticals I began to experience low grade  peripheral neuropathy (numbness in fingers and toes) and dysgeusia (taste change).  We took a brief "holiday" with two cycles of Keytruda alone.  My adverse effects began to subside and my hair began to return.  I then had one cycle both at a reduced dose of Padcev. 
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With a second negative ctDNA test and previous positve results reported in earlier posts - we agreed in consultation with my care team to suspend Padcev and maintain Keytruda.  We also agreed to continue to keep my bladder (no radical cystectomy or chemo-radiation) and monitor status with periodic ctDNA and imaging.

I am interested in collecting data from patients who have experienced a complete pathological response to Padcev+Keytruda treatment after TURBT (prior to radical cystectomy or chemo/radiation) to inform a safe dose de-escalation strategy.

I am also interested in gathering from any patients who have used fasting to avoid adverse effects with Padcev+Keytruda treatment.