A halocline is a term used in oceanography to define a strong vertical salinity gradient within a body of water. I first heard this term while watching BBC’s Planet Earth narrated by David Attenborough. (Man, that guy has a voice!) The cave episode shows divers trying to reach the ocean from one of Mexico’s underwater, freshwater caves. The place where freshwater and saltwater meet, presto! Halocline. The two types of water, each with their own unique properties, separate themselves but maintain the same physical space. Surprisingly, life still exists in what David Attenborough calls one of the most inhospitable environments on the planet: a lightless underwater cave engaged in a tide-regulated battle between salt and fresh water. What could live here?
In August, after waiting a couple months for the next possible treatment, a tumor in Kathryn’s pelvis began to bleed uncontrollably. The tide rolled in. Quick thinking and an excellent vascular surgeon saved her life. Shortly after this event, she started taking Lorlatinib, a trial drug designed to target the ALK mutation in her cancer. Specifically, Lorlatinib targets her secondary mutation, G12O2R. This mutation is known to cause resistance to all the other ALK inhibitor on the market and is the reason why she has had progression on her previous two targeted therapies. The pattern of survival for those with ALK, and specifically the G12O2R mutation, is to jump from one targeted therapy to the next once the cancer grows resistant. They follow this pattern trying to extend their lives, always waiting for the bad news to eventually come.
Kathryn’s cancer has not yet grown resistant to Lorlatinib. In fact, she’s had the longest run on this TKI (class of drug that Lorlatinib belongs to) than any other; and, if it were not for three small liver lesions remaining, she would be considered “No Evidence of Disease.” The tide rolled out!
We should be ecstatic. We should be celebrating such an amazing response to Lorlatinib. And we are! We believe it’s a miracle that she went from nearly dying in early August to almost NED today. I thank God for the extension my wife has been given. The days my children and I have had with her since she started taking Lorlatinib have been wonderful, amazing, priceless, legacy-building days.
Yet we are living in a most inhospitable place. A place where we anxiously wait for the next tide of progression to roll in while still celebrating life. A place where hope and despair are constant combatants, yet no one wins or loses, they remain in suspense. A halocline.
I am running to raise money for research in to the next TKI that will extend her life or save it. After Lorlatinib, there are few options. We need more research and I need your help. Please consider a donation of any amount. It’s the new research that gives us hope, that balances out the knowledge that this is stage four lung cancer that has a 4% five-year survival rate. Help us develop new therapies. Help us and other families like us thrive in the halocline.