We’re back at NYU for round two of chemo and a checkin with Andrew’s oncologist. We had a feeling but were happy to confirm that Andrew’s weight is up—even a few pounds over what he weighed on chemo day 1. We’re attributing that in large part to a new anti-nausea med that comes with a side effect of increased appetite. This is encouraging ahead of what could be a few days where eating and drinking is tough—though hopefully the new med helps that too.

When we got here, they took labs, and we learned that his neutrophil count was very slightly below the bottom limit to move forward with chemo. (The risk is that he could have prolonged severe immunosuppression if we add more chemo on top of low white blood cell counts.) However, we already planned for him to get a booster injection on Wednesday, so we’re not changing today’s treatment.

Andrew was looking forward to discussing results from his biopsy today. Unfortunately, the tumor specimen that was submitted to the lab wasn’t sufficient to return a result, but the liquid biopsy (aka what’s in his blood) came back with a lot of info. Most notably, we saw lots of BRCA2 gene mutations—this was a given since his BRCA2 mutation is why he has cancer to begin with—and also KRAS mutations. In a weird way, this was great news, as this is a common and well-researched mutation in pancreas cancer. There are treatments that specifically target KRAS coming soon, which we’ll want to take advantage of.

Initially Andrew said he wanted to undergo a second biopsy so we could learn more about the solid tumor—he’s in relatively good shape right now and may be able to tolerate anesthesia and other associated risks. His doc doesn’t like that idea because 1) we already got a lot of genetic info from the liquid biopsy and 2) there’s risk of bleeding and they’d have to pause blood thinners before a procedure, which isn’t safe right now. In the future, when we’re closer to needing new data for targeted therapies, and he’s been stable on blood thinners without new strokes, we’ll reconsider.

We just got settled in his infusion suite and will be starting his pre-meds then chemo soon. Please pray for less nausea and a smoother experience than we’ve had to date. Oh and no allergic reactions. We did get to see another therapy dog, Elmer, on the way in for some good luck vibes.