Progression Confirmed And More
 

Friends,
I had a six-month run on Xeloda/Tykerb and Herceptin, but it's over. Liver mets have grown in size and I have at least one new one. I have some thinking to do--know we know where we stand.

1) I'm getting a Mediport on Tuesday. Is there a huge difference between it and the Power Port I've heard so much about here?

2) Do you still feel the stick of the catheter?

3) Looks like I have plenty of options, including intra-hepatic chemo, but my onco is leaning toward T-DM1 with Taxol. For those on T-DM1, did you you have with Taxol? Seems best efficacy is this combination.

Chrisy, did you lose your hair on this one or were you without Taxol? I had 32 infusions of Taxol and lost my hair, but it came back.

Any treatments you would like to suggest? Personally, I think I want to go with Navelbine and Herceptin.

And it looks like I have a very smart cancer.

Also found on yesterday's PET/CT was an area of interest on a cervical bone near the base of skull (where I've been feeling some discomfort like my neck getting stuck for a minute). This area is not suspicious for mets, but they want an MRI for that to confirm it's probably degenerative osteo.

So, here I am...dusting off after the blow.

Karen

Re: Progression Confirmed And More
 

I am sorry, Karen. Although I can't answer any of your questions, I am sending you a hug.

Kelly

Re: Progression Confirmed And More
 

Karen,

I've been on T-DM1 for 7 months now. No hair loss. I am on the Marianne trial and along with T-DM1 I am either getting a placebo or Pertuzumab. It was my liver mets that completely disappeared after 3 cycles! They have not come back. The rest of my tumors did shrink a little and have since then remained stable. I have a numbing cream for my port Emla cream, and I do not feel the stick at all. The one time I forgot the cream they iced my port and I barely felt it at all. I couldn't tell you which port I have however, but its worked like a charm the entire time and the surgery to have it placed went very quickly and smoothly. I hope that helps with a couple of your questions. I've already been told Tykerb will more than likely be my next drug if I progress on T-DM1, so then I will have questions for you. Hang in there! You've survived so much already and I am in awe when I see your history! Hugs to you!

Re: Progression Confirmed And More
 

Karen,
Still sending love and prayers.
Wish I could give you a hug in person!
Denise

Re: Progression Confirmed And More
 

Karen,
I've been on TDM-1 for over 2 years and stable. No other chemo. The best of luck to you!
Kathy T

Re: Progression Confirmed And More
 

Karen,

Sounds like you have a lot of options: chemo, a trial, and a local procedure. Good! And ... I stand corrected!

Joan

Re: Progression Confirmed And More
 

Karen,

Sorry about your progression. Sending love and prayers.

Re: Progression Confirmed And More
 

Karen, I was on TDM1 as a single agent, no Taxol. So with the Taxol component it would definitely be a hair challenging event.
The intrahepatic chemo sounds promising, from what I know about it there is less general systemic toxicity because it is confined to the liver area.

TDM1 - With approval still likely to be a ways off, I'd be looking for a way to gain access to it in a trial. The chemo piece is not a taxane, so may outsmart that stupid tumor - plus give it the double whammy with the taxol. The other options you are considering would then be available to you if need them.

I know the hair thing IS a big deal. In the summer I was trying to get into a taxol-based trial and was researching "hair options" but not with glee. Still, we both know that if it is the best option it's worth it.

On the bone issue, I wonder why you would be getting an MRI rather than a bone scan...but I also remember getting a scan that noted "degenerative changes in bone" which had me freaking out until my oncologist reminded me that I was getting older, and that was the whole idea. Still, even if it is not suspicious for mets you probably should consider bone-strengthening meds in your total package. And definitely get it checked out so you know what you're dealing with.

On the positive side, it is a good thing to have several viable options on the table! You will make the right choice for you.

Re: Progression Confirmed And More
 

Karen,

Sorry to hear about your progression, but glad you have a few options out there that to kick that cancer to the curb!!

all the best
caya

Re: Progression Confirmed And More
 

Sorry Karen to read this, the Power port is better as you can use it for nuclear scans too!

Sending my good wishes and sorry I have no advice to offer!

Re: Progression Confirmed And More
 

Karen:

Dang! tdm-1 is a sensational drug. I know u will think of the right thing to do. I'm coming to NY quick - I'm getting WAY excited.

Hugs,
Kim

Re: Progression Confirmed And More
 

You can ask for a prescription for numbing cream and put it around your port an hour before your appointment. Drink plenty of water and keeping the area to be accessed warm before your appointment.
Ports are great !! Although I have known people who have had problems with their ports I have had the same one since March, 2000. We can also use ports for blood tests.
Good luck with whatever you and your oncologist decide to do. You are a strong proactive woman. Stay that way. It helps.

Re: Progression Confirmed And More
 

I am at a loss reading your post, Karen. Sending all my prayers your way. Stay strong, you will beat this!!

Re: Progression Confirmed And More
 

Hang in there, Karen.

Re: Progression Confirmed And More
 

Hope all goes well, sending good thoughts and prayers your way.

Re: Progression Confirmed And More
 

Karen,

This new study from Korea reported excellent result of paclitaxel (a Taxane), gemcitabine (Gemzar), and trastuzumab (Herceptin) on Stage II/III patients. (Logically it will be effective for other stages) It might be something worth checking into.

Breast Cancer Res Treat. 2011 Nov 18. [Epub ahead of print]
Phase II trial of preoperative paclitaxel, gemcitabine, and trastuzumab combination therapy in HER2 positive stage II/III breast cancer: The Korean Cancer Study Group BR 07-01.

Im SA, Lee KS, Ro J, Lee ES, Kwon Y, Ahn JH, Ahn JS, Kim JH, Kang HS, Shin KH, Noh DY, Park IA, Kim SB, Im YH, Ha SW.
Source

Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Abstract

An addition of trastuzumab preoperatively to chemotherapy for human epidermal growth factor receptor 2 (HER2) positive breast cancer improved relapse-free survival (RFS).

This study was designed to evaluate the efficacy and safety of preoperative paclitaxel, gemcitabine, and trastuzumab (PGH) combination for HER2-positive breast caner. Pathologically, proven node positive stage II/III breast cancer patients with adequate organ function and no history of anti-cancer therapy were eligible.

Patients received weekly trastuzumab with paclitaxel 80 mg/m(2) and gemcitabine 1,200 mg/m(2) on days 1 and 8, every 3 weeks for 6 cycles. Postoperatively, patients completed trastuzumab for 1 year and hormone therapy for 5 years if indicated. All patients received postoperative radiation therapy. Of 53 enrolled patients with a median tumor of 5.3 (range, 2.0 to >12) cm; 43.4%, T3/T4; 75.4%, N2/N3; and 45.3%, positive hormone receptors.

The pathologic complete response (pCR) rate was 58.5% in both tumor and lymph nodes. Grade 3/4 adverse events were neutropenia (32%), febrile neutropenia (0.6%), and transient elevation of AST/ALT (1.6%) during a total of 318 cycles.

All patients maintained normal cardiac function. With a median follow-up of 40 months, 3-year RFS rate was 84% with 91.7% distant metastasis-free survival rates. Remarkable pCR rate was obtained with non-anthracycline-based PGH therapy for HER2-positive stage II/III breast cancer. Adverse events were mild with few incidences of febrile neutropenia.

Re: Progression Confirmed And More
 

Hang in there Karen. I know you will and your onc will come up with a good plan going forward that will knock out those pesky mets.

Re: Progression Confirmed And More
 

Karen,

Hate you are having to deal with this, but know you will make the right choices from the may available.

Re: Progression Confirmed And More
 

Thank you, everyone, for sending your thoughts and wishes. I caught every one!
OK, I have a three-week washout period. Seeing intra-hepatic doctor who will evaluate my candidacy for treatment. Then, if I qualify, I have a slot for T-DM1 in 20 days. Wait and see, wait and see, wait and see.
Weathered more than this, so I am grounded after being pushed into the whirlwind...and look forward to the next step.
Love
Karen

Re: Progression Confirmed And More
 

Karen, Wishing you the best...there are other good combos waiting for you. I thought you asked about Navilbene a while back..but perhaps I am confusing posts. But, just in case, I was on it with good success to remission with xeloda-hercep-in a clinical trial. Had good results and only some hair thinning. Stay strong. Ceese