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Trish · 07-31-2010, 04:29 AM

Hi Galina
I was on Tykerb (Lapatanib)and Xeloda (Capcitabine) combination for liver mets for about a year and it was very successful, but I did show regression after a time. I live in Australia and we have a government Pharmaceutical Benefits Scheme that funds treatments that are rigorously evaluated. Lapatanib is only funded in combination with Capcitabine (Xeloda) as they consider that gives the best result.
Liver mets were found Dec 2006 (CA 15-3 was nearly 2000 at that time) and I had Herceptin alone and in a range of combinations. Herceptin/Taxol combo was the most effective and TMs dropped to 68 before they started climbing again. Herceptin was subsequently paired with Gemcitabine, Navelbine and Vinoralbine, Carboplatin and Taxol, but by December 2008 CA15-3 was 819.At that point I switched to the Tykerb/Xeloda combination. By mid January CA 15-3 had dropped to 228 but unfortunately during that time I had been hospitalised twice with dehydration owing to severe mucositis resulting in vomiting, diarrhoea and mouth ulcers. Once the dose was dropped (from 5 Tykerb daily i.e. 1250mg to 4 daily i.e. 1000 daily and Capcitabine from 4 to 3 daily the vomiting ceased and the diarrhoea became manageable.I did have hand/ foot syndrome and some worsening of my peripheral neuropathy in my fingers and toes that I originally contracted when I was on Taxol. However I found all these side effects tolerable. By Jan 2010 the liver mets had again progressed and CA15-3 had risen from a low of 58 in Oct 2009 to 124 in Feb 2010. I was started on Herceptin in combination with a trial drug but progression continued until April 2010 when I commenced Herceptin and Tykerb in combination. Unfortunately there has been further progression (CA 15-3 most recently 512) and I am now considering an Abraxane/Tykerb combination. In short I would recommend try the Tykerb/Xeloda combination as it gave me a progression-free year. I am now prepared to pay for Tykerb myself as it seems to have benefit for me. I would only suggest you ask if there are any trials of TDM-1 that you would be eligible for before you begin. I am hopeful that one day I will have access to TDM-1 as from reading this site it looks very promising. I plan to do what I can to remain healthy enough to benefit from that drug.
I wish you the very best for your treatment.I have had enormous benefit from my treatments to date and am enjoying every day with my husband, children, extended family and friends.
Trish from Melbourne ,Australia.

07-31-2010, 04:29 AM	#13
Trish Senior Member Join Date: May 2010 Location: Melbourne, Australia Posts: 434	Re: Lapatinib + Xeloda = any hope? Hi Galina I was on Tykerb (Lapatanib)and Xeloda (Capcitabine) combination for liver mets for about a year and it was very successful, but I did show regression after a time. I live in Australia and we have a government Pharmaceutical Benefits Scheme that funds treatments that are rigorously evaluated. Lapatanib is only funded in combination with Capcitabine (Xeloda) as they consider that gives the best result. Liver mets were found Dec 2006 (CA 15-3 was nearly 2000 at that time) and I had Herceptin alone and in a range of combinations. Herceptin/Taxol combo was the most effective and TMs dropped to 68 before they started climbing again. Herceptin was subsequently paired with Gemcitabine, Navelbine and Vinoralbine, Carboplatin and Taxol, but by December 2008 CA15-3 was 819.At that point I switched to the Tykerb/Xeloda combination. By mid January CA 15-3 had dropped to 228 but unfortunately during that time I had been hospitalised twice with dehydration owing to severe mucositis resulting in vomiting, diarrhoea and mouth ulcers. Once the dose was dropped (from 5 Tykerb daily i.e. 1250mg to 4 daily i.e. 1000 daily and Capcitabine from 4 to 3 daily the vomiting ceased and the diarrhoea became manageable.I did have hand/ foot syndrome and some worsening of my peripheral neuropathy in my fingers and toes that I originally contracted when I was on Taxol. However I found all these side effects tolerable. By Jan 2010 the liver mets had again progressed and CA15-3 had risen from a low of 58 in Oct 2009 to 124 in Feb 2010. I was started on Herceptin in combination with a trial drug but progression continued until April 2010 when I commenced Herceptin and Tykerb in combination. Unfortunately there has been further progression (CA 15-3 most recently 512) and I am now considering an Abraxane/Tykerb combination. In short I would recommend try the Tykerb/Xeloda combination as it gave me a progression-free year. I am now prepared to pay for Tykerb myself as it seems to have benefit for me. I would only suggest you ask if there are any trials of TDM-1 that you would be eligible for before you begin. I am hopeful that one day I will have access to TDM-1 as from reading this site it looks very promising. I plan to do what I can to remain healthy enough to benefit from that drug. I wish you the very best for your treatment.I have had enormous benefit from my treatments to date and am enjoying every day with my husband, children, extended family and friends. Trish from Melbourne ,Australia.