[Nguyen]

Below is the 5 Her2Climb trials. It’s unlikely you can get in 2 and 3 since you already had kadcyla (T-Dm1) and are having Enhertu. Enhertu should be helping you with your brain met. Tucatinib has some activities for brain met so a Her2climb trial is a good idea, or can you get it in Australia without going through a trial. If you are actually entering a trial, it is not likely that you can add another med to a trial beyond what are specified by the trial.

Regardless, Doxil is a “slow release less toxic” form of Adriamycin. You already had Adriamycin in the AC combination back in 2000. So you should remind your oncologist of this. Although I understand (can’t remember where I read it) after a long period of time (years) a previously used drug might work again.

If you can get genetic sequencing done on your tumor, discuss with your oncologist to sequence tissues from the all the met sites, particularly the brain and liver. Your tissue samples from previous operations should be stored in paraffin block somewhere. It’s likely tumor biology change with treatment (selection/survival pressure) and also from one met site (or primary) to the next.

Best wishes.


HER2CLIMB: Tucatinib plus capecitabine and trastuzumab versus capecitabine and trastuzumab alone 1.
HER2CLIMB-02: Tucatinib plus ado-trastuzumab emtansine (T-DM1) versus placebo plus T-DM1 2.
HER2CLIMB-03: Tucatinib plus trastuzumab deruxtecan (Enhertu) versus placebo plus Enhertu .
HER2CLIMB-04: Tucatinib plus trastuzumab and pertuzumab versus placebo plus trastuzumab and pertuzumab .
HER2CLIMB-05: Tucatinib plus trastuzumab and vinorelbine versus placebo plus trastuzumab and vinorelbine .