Tykerb + Xeloda success stories
 

Dear All,
I am utterly confused at present on the chemo combination. More I read on the internet more I get confused as to whats the best combination for me.
I have been diagnosed with Metastatis BC with mets to spine, brain, liver, lung and subclavical bone.
The treatment plan has been as below:
Whole Brain radaition 10 sittings done
Started with Tykerb + Xeloda combination today.

Can all of you who have been on Tykerb + Xeloda let me know on your success. Please please rspond.

I have been thinking whether adding Herceptin would be a better option or starting with TDM1 or with Perjeta...
What would be the best option, please give your view.

Thanks,
Rupali

Re: Tykerb + Xeloda success stories
 

Hi;

I had good success with Tykerb, xeloda, and Herceptin as a triplette together. But at that time TDM1 and Perjeta were not around.

In theory Tykerb can cross the blood brain barrier. Note there have bee several studies in the metastatic setting which it was shown that laplatinib + chemo + herceptin works better than Laplatinib and chemo alone, particularly in Her2+ and ER+ patients.

From last Feb ASCO meeting by Dr. Rugo
http://www.ascopost.com/issues/febru...e-in-2013.aspx

"We have learned that we can improve outcomes by overcoming resistance through combined signal blockade targeting different parts of the HER pathway. We are already doing so by adding lapatinib (Tykerb) to trastuzumab, and have seen that pathologic complete response rates are high—47% to 60%—though lapatanib does add toxicity. As a single agent (combined with chemotherapy) lapatanib is inferior to trastuzumab, probably because it is difficult to administer easily (due to unpredictable toxicity, especially diarrhea). In addition to the data seen in the neoadjuvant setting, the single-agent lapatinib arm in the eagerly awaited adjuvant ALTTO study was closed due to futility, meaning that lapatinib with chemotherapy in the adjuvant setting was inferior to trastuzumab or the combination of trastuzumab and lapatinib. This is in keeping with other studies showing that lapatinib by itself is inferior, though it can be an important partner to trastuzumab. Other means of combined HER family blockade are needed."


I think most of us with mets would say to never drop the herceptin from the plan. Even if you have progressed, add to it and block it has many ways as you can.

all the best

Re: Tykerb + Xeloda success stories
 

Brain and Spine involvement is serious. Are you in the US or somewhere else? I am thinking that I would go with Intrathecal Herceptin (and if outside the US Perjeta) for that issue. Perjeta and Herceptin systemically is showing really good results for the other areas. Send me a private message for more info on why.

Re: Tykerb + Xeloda success stories
 

I would advise TDM-1 (Kadcyla) and brain radiation. The TDM-1 includes Herceptin. Please keep us updated.

Re: Tykerb + Xeloda success stories
 

Some great results with Intrathecal Herceptin and systemic TDM-1 with Nina. With your additional mets, I would do systemic TDM-1, Perjeta, and Taxane. The three drug regimen is tough on side effects, but pretty darn effective. I think this will be the preferred method in five years, with IT Herceptin/Toptecan for the brain, but you need to start now.