[chrisy]

I don't know the specifics of the trial you are in, but generally, the study sponsor pays for the investigational drug especially if it is not FDA approves yet, and for procedures which are not considered "standard of care". You/your insurance is billed for standard of care drugs/procedures. You should be able to get specific answers on this from the study folks and possibly the "informed consent" document You will be asked to sign if you haven't already.

For example, I am currently in a study with an investigational drug plus herceptin and taxol. As part of the study they do some extra labs and more frequent echo and ct scans than is normal standard of care. The study pays for the investigational drug and the "extra" labs and tests and my insurance is billed for the herceptin, taxol and "normal" tests. But each study is different, so you definitely want to clarify. Travel costs will probably be on your dime. Overall I'd say not to worry about that too much as the study sponsors structure things so that people are able to participate.

As for what to expect on day1, again that varies by study. Are you just signing paperwork or actually starting treatment? I strongly suggest you call them in advance if possible and find out what the schedule is because if you are starting treatment it is likely to be a Long day as they may do initial doses over a longer periodic time to be sure you are safe.

I was in a TDM1 study (as single agent) and although it was not, for me, a cure it wiped out my liver mets and held it for over 3 years with minimal bothersome side effects and great quality of life. For me I had mild fever/headache a couple of days after infusion. It whacks most poeples platelet counts and for me it increased liver function lab values. But then again, so do most chemos, and worse!

Good luck, TDM1 is a great drug and I know you'll do fine!