Mexico!

Welcome to Mexico City

Our trip home was full of wonderful events. We celebrated our bride to be, Amy, with an amazing group of her family members and friends and we attended Romeo Chocolate’s evening of chocolate and wine. There was a huge turnout. Thank you to everyone who participated! The fund raiser resulted in $1,700 dollars that will be added to our PlumFund to cover Layla’s medical expenses.

Our Bride to Be Amy with Layla

Our Bride to Be with her Crew

Celebrating Amy

Layla and her Tour Guides helping at Romeo Chocolates

Great turnout at Romeo Chocolates

We spent Monday traveling to Mexico City. We were picked up at the airport by a driver from Dr. Williams team. We are staying in the Santa Fe area of Mexico City conveniently located next to a mall called SAMARA. Upon check in at the hotel, the front desk clerk was very curious to know the meaning of my name going on to explain that the hotel is connected to a mall that bears the same name. That was pretty cool and convenient as there are a lot of dining options at SAMARA.

Approving of the Sign

Walking to Dinner

Mexican Feast

On Tuesday morning, we received some great news from Dr. Rosenberg’s office. Layla’s tumor markers from last Thursday have all come down dramatically indicating that the treatment is giving some promising results. The tumor marker values are now:

• CA 27.29: 742 down from 1511 at the start of treatment (this is the primary marker we follow)
• CA 125: 245 down from 1767 at the start of treatment 
• CA 15-3: 498 down from 821 at the start of treatment

Wednesday morning, we are picked up from the hotel and driven to the hospital where Layla is expected to spend one or two nights following the Intra-tumoral injection procedure.  Transportation logistics are always arranged by Dr. Williams team. The hospital is about 4 km. away from the hotel but the ride takes about 40 minutes in traffic on a very rainy day. It is unusually cold that day with a forecast of 100% rain and a high of 58 degrees. 

On the way to the Hospital in the Morning

The nursing staff at the hospital are very nice with very limited English but always prepared with a google translate app that tells Layla in English what they need. Our day at the hospital is long. We got to the hospital early and consulted with the doctors before Layla was taken in for the procedure which took a little over an hour for a CT scan, anesthesia, and the CT-guided injections. Dr. Williams injected a couple of the tumors in Layla’s liver with OX40, Yervoy, and CpG, modeled after the successful Stanford mouse study. The CpG injection trains the immune cells to recognize Layla’s cancer-specific antigens and the OX40 and Yervoy activate the immune response. Although the drugs will not last in her system beyond a few weeks, if it works it should create a longer-term immune response with T-cells that remember the antigens.  OX40 is currently in Clinical Trials in the US (with some modifications) as IV therapy but is considered more promising when injected directly into tumors.  Yervoy and CpG are already FDA approved and are in use in the US (although rarely injected directly into tumors).  Dr. Williams indicated that he used to give patients the option to get treated in the US or Mexico, but started seeing significantly better results when treating patients in Mexico since he has more flexibility and is able to make adjustments that make the treatment more effective.  After seeing this pattern, he began only treating patients in Mexico.  Dr.  Williams is very personable. He is a winner of the 2018 Vince Lombardi Leader for a Cure Award. He dedicates a lot of his time for research and explains thoroughly his approach and the ongoing advances in the immunotherapy field.

When Dr. Williams came out he said he saw about a 10-15% shrinkage in the liver lesions compared to the previous CT scan from the end of September.  We believe that the lesions had grown after we got the previous CT scan and then shrunk again.  Our best guess is that the cancer could have shrunk by 30-40% from when we started treatment in Florida based on our review of the data.  Dr. Williams also indicated that there were no new lesions.  All good news!!

Olaf keeping an eye on Layla at Night  

Layla with Dr. Williams and Dr. Vargas on Discharge Day

If we see a response to the immunotherapy, then it could be immediate or it could be significantly delayed. Dr. Williams said one patient of his had stabilization for 9 months before there was finally regression.  If there is further shrinkage in the coming weeks, we will not know if it is due to the immunotherapy or the continued combination treatment.  Dr. Williams would like to see CT scans in 6 weeks, 3 months, and 6 months and a PET scan in 9 months.  Our hope is that the combination of Dr. Rosenberg’s treatment and Dr. Williams immunotherapy procedure will yield a remission with the immunotherapy leading to an eventual cure. 

On Thursday morning, Dr. Williams came and discharged Layla. She is feeling good overall with minor discomfort on her right side where the procedure was. Depending on how Layla feels the next couple of days, we might do some sight seeing or chill at the hotel. We leave back to Boca Raton on Sunday and re-start treatment the following Monday.

Hasta Luego!

Layla and her amigos (Derek, Wes, Nina, Samara and Olaf)