herceptin discontinued due to LVEF drop

[Jyber]

My oncologist discontinued my herceptin treatments because my ejection fraction dropped more than 10%. It is still in the normal range (55%) but she says because of the significant drop (EF was originally 65-70%) she will not continue with the herceptin because it is clearly causing heart damage in me.
I have had another echocardiogram more than a month after my most recent herceptin and the result is the same -- 55%.
Can I expect the EF to recover? I need it to go to 60% in order to try the herceptin again.
Advice from anyone who has been through this would be deeply appreciated. I feel that herceptin is a weapon I don't want to lose.
Thanks!

[Janelle]

I think that EF frequently go back up with a break from Herceptin. Also, I consulted with Dr. Slamon about how long I should take Herceptin and asked him how concerned I should be if my LVEF dropped and I had to discontinue it. Basically, he told me that I should not be overly concerned if I could not finish out a year of herceptin becasue the one year mark is completely arbitrary. He said there is a study going on now that is testing a 9 week time frame. So let's hope your LVEF imprroves but don't lose hope that you received no benefit from the herceptin that you have had already.

[Jyber]

^^ Thanks, Janelle.
I got a total of 8 herceptin treatments (once every three weeks) from early June until early Novermber. Then it was stopped and I have been hoping for an LVEF recovery to resume (a herceptin "challenge" as my oncologist calls it). So by my calculations I got one fewer than half of the 18 herceptin infusions I would ordinarily get in a year.

GuessIcan just hope it was enough!

Has anyone resumed herceptin following a break?

[Lani]

I know of an 84 year old who got 5 months of herceptin before her LVEF dropped from 55% to 40%. She had had heart valve repair surgery 12 years previously and a pacemaker implanted 1 year before. It took about 6 or 7 months, but her heart function returned to baseline.

That said there are review articles with institution wide and multiinstitution wide experience with this. One is from MD Anderson, another by Sharon Hunt of Stanford and Edith Perez has reported on this as part of her reviews of the North American Herceptin trials experience.

I post many of these unless I think they will worry people more than help.

If you would like to hear more than anecdotal evidence, google Entrez PubMed and enter "herceptin cardiotoxicity" into the rectangle (not geakspeak, but I hope you understand my nontechnical description) and
feast on the wealth of information gathered and presented so far.

Don't be frightened to do so...it has been at least 80 years since Doctor's conversed mostly in Latin to keep patients out of the loop. Most of these articles are easily understood by most, particularly if you keep a webbased medical dictionary on hand for those words that really stump you.

Hope this helps!

[Jyber]

^^ Thanks, Lani. I will give PubMmed a try!