Has anyone had lapatinib and capecitabine with Herceptin and PErjeta
 

Hi,

My wife is currently on Perjeta and Herceptin. She has had Brain mets previously and no systemic disease. Has anyone had the combination of lapatinib and capecitabine with Herceptin and Perjeta? I'm trying to find a combination that reaches the brain.

Thanks

Re: Has anyone had lapatinib and capecitabine with Herceptin and PErjeta
 

Lapatanib (Tykerb) reaches the blood brain barrier. The dose usually is 1250mg daily. It comes in 250mg tabs (capsules ?) so you take 5 daily together. It does tend to cause diarrhea.

Paul

Re: Has anyone had lapatinib and capecitabine with Herceptin and PErjeta
 

lapatinib is one. there is a promising her2 tx. for brain mets in phase II trials. ont380, a small molecule drug like lap. in trial it's added to kadcyla. i heard it got fast track approval from fda - so available next yr. ? some stage iv could ask for compassionate use , esp. if they live far from the always too slow, small trials. in a better system ont380 would already be out and be an insurance for her2 stage iv pts who have already had brain mets - an insurance against brain reocc. but we have a lousy approval system due both to pharma and fda and our legislators and advocacy grps indifference. if ont380 was a war weapon that killed ISIS the way it did her2 brain mets in the phase I trial the pentagon would already have it . war. but not us in our war that kills so many . i fight this slow approval system with virtually no compassionate use every chance i get . check out my wife " lorraine's story" on the goldwater institute Right To Try page.
in my opinion , kadcyla is stronger than herc/perj. they are genetics while kad. is genetic (herc) and a very powerful chemo attached together to maximize her2 impact. some evidence suggests kad. passes bbb too. but no clinical trial on that yet . kad. could kill residual her2 cancer in body more than perj/herc and thus keep it from returning to brain . and kad. is a chemo with generally fewer s/e than cap. / lap. my wife is stage iv her2 only but cancer free 5 yrs after kadcyla. she couldnt handle cap and lap. lap with diarrhea and cap with fingers/ feet skin splitting. she progressed on 7 or 8 chemo/genetic combos until kad. came along. she had a high her2 reading on the FISH test - 6 on scale of 10 . actually worked in her favor as Kad. honed in and hammered it . gone. not everyone gets this response but many do.

Re: Has anyone had lapatinib and capecitabine with Herceptin and PErjeta
 

I had capecitabine (xeloda) added to herceptin & perjeta- within 9 weeks it knocked out small spot in brain (same site as treated met - 9/2015 srs) & a few metastatic abd nodes. Plan to stay with this combo as long as possible.
Xeloda is a chemo & collateral damage is an issue, but learning to manage SEs & while it is worse than h/p alone, I'm insanely relieved to finally have some coverage in brain.
Did not add Tykerb - decided SEs not worth potential additional benefit. Xeloda crosses bbb & appears to be working well (everything crossed it continues to work!!), so no complaints. Agreed on ont-380 - cant wait to get it! Hope this may be helpful....

Re: Has anyone had lapatinib and capecitabine with Herceptin and PErjeta
 

Thanks for that, it's great news.