The drama continues Adriana again
 

Hi everyone,

It appears I have become resistant to Herceptin, which
I'm not surprised at all. Have never met anyone in my
situation - I'm a walking miracle and grateful for a great
response I've had - first patient my doctor has had.

So, what's next? Any advice? Has anyone tried halaven
- what was your experience? My doctor and I will discuss
Proton therapy? Appreciate anyone's experience with
this type of therapy as well. I'm down but not out.
perjeta will be added to Halaven. Will report to you
after two cycles. Thank you.

With Love and Gratitude,

Adriana

Re: The drama continues Adriana again
 

Hi Adriana,
Sorry to hear your news. How do the docs know you are now resistant to Herceptin? I am certainly hoping for a response as long as you have had! I can't offer advice, but there have been quite a few mentions of Halaven recently - a search of the site should bring up a lot. I haven't heard of Proton therapy.
I hope you have a great response to the new regime, with the targeted Perjeta and not too many side-effects from the Halaven. Let us know how you go.
Best wishes.... Pam

Re: The drama continues Adriana again
 

Adriana

I don't believe in Herceptin resistance. It is just that the cancer has found a way around it. However, it is probably containing and helping some of the cancer cells. It is just not working on all of them. I would not go off it but add something to it. Perjeta, Tykerb maybe an off label Her1 inhibitor (usually given for lung cancer) like Tarceva. Remember Tykerb is a Her1 and Her2 inhibitor. I will keep thinking.

Re: The drama continues Adriana again
 

Neratinib? I think so.

http://www.ncbi.nlm.nih.gov/pubmed/24009064

Karen

Re: The drama continues Adriana again
 

Thank you Karen, I will definitely check in with my doctor about Neratibin....It looks promising..

Re: The drama continues Adriana again
 

Dear Adriana -
Seems like you just need to switch up what you are taking with Herceptin. Vitamin H is a mighty powerful drug, but it can't close all the HER pathways by itself.
I will be interested about your onc's recommendation.

Tell us about the Proton - I think it a "zapper" of some kind. Have you looked at Cyberknife for the troublesome place?

Re: The drama continues Adriana again
 

Adriana,

Below is an abstract about the Proton therapy:

Radiat Oncol. 2013 Mar 24;8:71. doi: 10.1186/1748-717X-8-71.
Proton radiotherapy for chest wall and regional lymphatic radiation; dose comparisons and treatment delivery.
MacDonald SM1, Jimenez R, Paetzold P, Adams J, Beatty J, DeLaney TF, Kooy H, Taghian AG, Lu HM.
Author information
Abstract
PURPOSE:
The delivery of post-mastectomy radiation therapy (PMRT) can be challenging for patients with left sided breast cancer that have undergone mastectomy. This study investigates the use of protons for PMRT in selected patients with unfavorable cardiac anatomy. We also report the first clinical application of protons for these patients.
METHODS AND MATERIALS:
Eleven patients were planned with protons, partially wide tangent photon fields (PWTF), and photon/electron (P/E) fields. Plans were generated with the goal of achieving 95% coverage of target volumes while maximally sparing cardiac and pulmonary structures. In addition, we report on two patients with unfavorable cardiac anatomy and IMN involvement that were treated with a mix of proton and standard radiation.
RESULTS:
PWTF, P/E, and proton plans were generated and compared. Reasonable target volume coverage was achieved with PWTF and P/E fields, but proton therapy achieved superior coverage with a more homogeneous plan. Substantial cardiac and pulmonary sparing was achieved with proton therapy as compared to PWTF and P/E. In the two clinical cases, the delivery of proton radiation with a 7.2 to 9 Gy photon and electron component was feasible and well tolerated. Akimbo positioning was necessary for gantry clearance for one patient; the other was treated on a breast board with standard positioning (arms above her head). LAO field arrangement was used for both patients. Erythema and fatigue were the only noted side effects.
CONCLUSIONS:
Proton RT enables delivery of radiation to the chest wall and regional lymphatics, including the IMN, without compromise of coverage and with improved sparing of surrounding normal structures. This treatment is feasible, however, optimal patient set up may vary and field size is limited without multiple fields/matching.