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View Full Version : time for new treatment plan-is xeloda still effective?


Shell
03-17-2006, 05:23 AM
With a reoccurrence to lungs, I have been on xeloda since May. Orignial treatment for stage IIIC was neoadjuvant TEC(taxotere)/x4, then lumpec + SNB (negative), then TEC/x2, followed by radiation and 3 months of navelbine/herceptin preventatively. Reoccurrence in < year in lymph nodes. Had complete axilla dissection, then 3 months of taxotere/herceptin. Reoccurrence towards end of treatment, with nodes in lungs.

I am paritcipating in the xeloda with or without lapatinib clinical trial, in which I drew the arm only getting xeloda. Initial scans in xeloda treatment plan were great - last 2, though, have shown minimal, but progression, of some measured areas. I need to evaluate whether to stay on xeloda, or concede it is not working, or perhaps add another chemo to the mix. Any thoughts on options?

Shell

Lolly
03-17-2006, 08:14 AM
Shell, my first thought would be to add Herceptin back into the mix. Of course, you'd have to drop out of the trial, but I assume you're going to be doing that anyway with progression and needing to add or switch chemo's.

I'm on a combination of Herceptin/Navelbine/Xeloda for stubborn mets to the lymph system, and since adding Xeloda last month we've seen measurable improvement as opposed to stable disease. This is a departure for me, as for each of three recurrences to these same nodes since 2001, we've used just Navelbine with Herceptin with good results. My onc felt that since I had good responses with Navelbine, and periods of either remission or stable disease in between while on Herceptin alone, that Navelbine was still a good option for me, and he has been right on.

Although you had Navelbine previously, I'm assuming from your post that you had recurrence some time after finishing, so Navelbine/Herceptin (considered quite synergistic together) may still be an option for you if you didn't progress while ON Navelbine. Also, Navelbine is considered very effective against lung mets.

I hope some others post with their treatment decisions, as I'm sure you're worried and anxious to put together a plan. Hang in there, you DO have many options still, and I would hope one of them is still Herceptin :)

<3 Lolly

sarah
03-18-2006, 07:48 AM
Lolly, (or anyone else with good info)
I've a HER2+ ER- PR- friend who tried Navelbine when her cancer first recurred but her WBC dropped to 8 (I think that's what she said) and despite several injections, it didn't improve so she had to go off it despite its good effect on the cancer. Well now she's got mets in the lung. Any thoughts as to what they could give her so she could go back on Navelbine? She's currently on Caelyx but the cancer markers are not going down.thanks
sarah

Unregistered
03-18-2006, 03:00 PM
This is a thought provoking article if you did not see the other post, and may be of interest, in terms of adjuncts to consider.

As with all things it should be treated with common sense, checked, and any changes in diet etc checked with advisors etc.

RB


http://www.cabnr.unr.edu/cabnr/news...onandcancer.pdf

Lolly
03-18-2006, 10:49 PM
Sarah, some people just don't do well with Navelbine; low blood counts have been a problem for me also. We've used a combination of halving the Navelbine dose every other week to keep my white counts just high enouth, and Aranesp for the red counts. Now, though, I'm on permanent half doses, since I started Xeloda. Counts are ok.

I have a friend who couldn't tolerate Navelbine either. Xeloda/Herceptin worked very well for her for a long while for IBC. Another friend with Her2 lung mets reached NED on Xeloda/Herceptin; is your friend still on Herceptin and have they tried Xeloda?!

<3 Lolly

sarah
03-19-2006, 09:05 AM
thank you for your answers. yes, she's on Herceptin and Caelyx but I'm sure now they'll change to something else. The Navelbine helped the cancer but destroyed her white blood cells. I'll ask her about the other drugs you mention. she sees her onc tomorrow. Also she's in touch with the premiere HER2 doctor in Rotterdam, known as Dr. Her2 so maybe he'll have some ideas also - I hope so.
keep sending any ideas.
many thanks
Sarah

sarah
03-19-2006, 09:08 AM
Also unregistered, I tried to access this site http://www.cabnr.unr.edu/cabnr/news...onandcancer.pdf but even shortening I only came up with an argricultural site - had no idea where to go. could you explain it more?
thanks
sarah

sarah
03-19-2006, 09:26 AM
Lolly,
Many thanks again for your answer. another question, did you ever need to get something to boast your white cells, and if so, what? I get the feeling that Navelbine would be good for her but she'd need to get something to keep her WBC up.
I think they may consider cisplatin(??) (or is it carboplatin??) which is apparently a gold standard of chemo??? but is very hard. since her husband just died suddenly, she's alone and I think they've been hesitant to give it to her but may now decide to.
Thanks Sarah

Unregistered
03-19-2006, 10:48 AM
sarahdalton

Sorry I copied the link, here it is again. See the "very thought provoking" post and caveats.

This is only one trial etc, and there could always be some other explanation, see other posts on diet balancing threes sixes etc,

It is accepted that improving omega three intake will if nothing else improve general cardiac health, and doctors are begining to look at it on a wider basis.

The important part seems to be balancing the threes and sixes, absolute consumption is less important, but the balance of my reading seems to suggest most would go for moderation - eg. cut out most oil in extracted form minimal quality olive, some flax or flaxseed and fish or oil

Usual caveats check out and talk to advisors.

RB


http://www.cabnr.unr.edu/cabnr/newsletter/pdf/nutritionandcancer.pdf

Unregistered
03-19-2006, 04:40 PM
Sarah,

I hope things look up from your freind. To have to face her situation and add to that the loss of support of a husband - it must be a terribly hard burden.

I hope your friend manages to find a little joy and a few smiles, and improves dramatically.

It is kind of you to help her.

RB

sarah
03-20-2006, 04:42 AM
thanks RB got the link to open this time.
Sarah

Lolly
03-20-2006, 03:28 PM
Sarah, I only had one incident of extremely low "absolute neutrophile" counts (the white cells that fight infection). That day they were 200, with the cutoff for receiving any chemo being 500. So that day I got a Neulasta shot for white cells. By the next week my neutrophiles had zoomed up to 5000! So Neulasta is very effective, but also expensive and some insurance companies balk at paying so it would be a good idea for your friend to ask the insurance person at her onc's office to try and get it "preauthorized" if her onc determines it's appropriate therapy for her. There's also Neupogen, but the treatment is a series of daily injections, so Neulasta is more convenient. Here's a link to CancerConsultants info page on both:

http://patient.cancerconsultants.com/supportive_cancer_news.aspx?id=18791

<3 Lolly

sarah
03-22-2006, 05:59 AM
Lolly,
Many thanks for your information. I'll let her know. We're both in France so who knows what's available here or not but if it's available, they'll give it to her. health is a right here not a cost. your advice is always so appreciated and you are so knowledgable and brave.
Hope you're doing well.
all the best
Sarah

connie
03-24-2006, 02:03 PM
Shelly,

After being dx'ed with IBC in June 2002, being NED (no evidence of disease) for four years, I have just had a reoccurence to my lung. My treatment has started after a wedge resection of my lung--clear margins but invasion of the vascular lymphatic system.... I am on navelbine/carboplatin/hercepton day 1 & 8, Hercepton also every week, and Xeloda day 1-14 (1500 mg every day).

How are you doing? I am still in the angry, I can't beleive this has happened again mode!!! But trying to but my best foot foreward!

Connie (KY)