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My wife has been on 3 weekly Herceptin for the last 11 months. She goes to the Royal Marsden in London (which I suppose is the UK equivalent of the Sloane Kettering or MD Anderson) a major centre for the HERA trial.
How the Prof explained it when she started was that in the early days they were still running trials on Herceptin safety and heart problems and were using a pessimistic model for the half-life of Herceptin in the body. Hence smaller weekly doses were used as being possibly safer and a reliable way of maintaining levels of Herceptin in the blood.
However, the view at the Marsden was that there was no difference in efficacy between weekly and tri-weekly as herceptin seemed to hang around in the body for quite a long time and there was no great evidence that the heart risks were changed with either regime. So at the Marsden at least they seem very relaxed about three weekly herceptin. Others we meet are on 3 weekly.
In fact, whilst they won't let Monica reduce her intervals by a couple of days, they are happy to stretch intervals to 4 weeks plus to cater for holidays etc.
It is more convenient and gives your veins a rest. Monica has not needed a porta-cath etc.
There may be other factors such as MUGA scores etc, but outside of trials 3 weekly seems to be common on this side of the pond.
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