[chrisy]

Hi, me again!

I've also been in a DM1 trial, since Feb 08 with great results. It is a very promising new approach and although it's a bit tougher than plain vanilla Herceptin, it's quite tolerable.

So, you see I do have some bias, but overall I think a TDM1 trial would be a very reasonable option for your friend. I think what you are saying in your post is that the Tykerb/Herceptin would be a short term thing, until she can get into the DM1 trial, right? If this is the case, the goal of the Tykerb/Herceptin is to keep things stable.

She has a "window" in which she will be able to get this drug on trial. She may not have another opportunity until after it is approved, which at earliest would be about a year. There are, of course, other types of trials out there as you note. But asTDM1 is further along than some of them, it has more data and has already shown efficacy.

I'd say, have her discuss the options (and why they are being recommended) with her oncologist. Bring up other thoughts as well.

Tykerb and Herceptin both target Her2, (Tykerb also targets Her1) but they do so in different ways. So Tykerb can work after Herceptin fails, and also there is some data that using the 2 in combination works well.

Tykerb is pretty easy to take, the main side effects are diarreah (which most people are able to manage with diet and Immodium) and in some cases rash. I found it very tolerable.

OK, next! "metastatic Her2 specialists"...
You didn't say where you/your friend are located, that might help people make suggestions. It's safe to say that any Comprehensive Cancer Center doing research treats a lot of metastatic disease, and also that much of the research going on is on Her2 targeted agents. Still, there are some who are specifically on the leading edge of this research.

I know I didn't answer your question. I was referred to a top research oncologist by...my local oncologist. The good ones are both familiar with and eager to work with the top docs. So it doesn't hurt to ask for a referral.

Chris