Ipilimumab

It seems like they always like to make these drug names as tongue twisty as possible. Ipilimimab, which I will refer to from here on as Ipi, is also branded as Yervoy. Ipi is quite different than the Vem I had to take. Vem was an oral tablet, just like popping pills for a headache or something. Ipi is a drug which needs to be infused and given intravenously. It is a very potent drug, very much like standard chemotherapy (except I should again state that it is not chemo, just the process is very similar). The potency means they can't just give me a shot and send me on my way.

It also has a short shelf life, so it needs to be made on the spot. If you look at the picture, it says at the bottom of the label it expires at 23:00 (11:00 pm) on the day I was there. This gives it roughly an 8 hour shelf life. Given it's price, I don't blame them for waiting until I'm actually in the center before calling the pharmacy to make the mix. It's mixed with a saline solution to cut the potency a bit while it's being fed into my body. It takes 90 minutes for the whole bag to go in, again due to the potency. They are giving my body time to disperse it so it isn't quite concentrated in one area. I don't think I'd like my arm to fall off.

So how exactly does the drug work? Well, it's not an immediate thing. Similar to how the Vem needs time to build up by taking it over a long period, Ipi needs time to kickstart my immune system. Even the doctors said I may not even see any side effects right away and could possibly take to the second or third infusion before anything begins to manifest. It's early yet, but I haven't seen any signs of the common side effects and hoping it stays like this for a while. After the joint pain from the Vem, I could use the respite of having to deal with crap.

Since the drug takes time to rev up my immune system, the best analogy I can think of is imagining starting a lawnmower. The first pull the engine probably won't even turn. The second pull, it kinda goes put stops quickly. The third pull turns the engine a few times and you think it's gonna go, but it dies out again. Finally, the fourth pull starts it up and it's time to cut grass. Think of the engine as my immune system.

However, the downside of this process is that we won't know how well it's working right away. I don't get another CT scan for 12 weeks and even that won't be conclusive that the drug is working. So there is a period of sitting on pins and needles, not knowing what is going on with the cancer. In fact, we probably won't get something definite from the doctors until 6 months down the line to see if there is any significant changes.