[SoCalGal]

I have to change my protocol, between progression and allergy to herceptin. I am trying to decide between a clinical trial for TAS116, and KADCYLA.

TAS116, is an oral anti heat shock protein that has an affinity for HER2+ cancer, and I have an old tumor assay that shows I am a good candidate for a HSP target. The "PRO" is it's oral, local, and they have an opening, it's a phase 1 but they have the dosing figured out, HSP have been around, and they just added space to the trial, so that says the early results are not killing anyone and might be helping. The "CONS" are the side effects; nausea, fatigue, loss of appetite, etc., the list goes on and on. First up on the severe list is a vision problem, which my onc said I focused on and stopped hearing more. I beg to differ. The trial investigator brought it up and risk to VISION is not something I can ignore. The problems are not blindness, and they resolve once the meds are stopped, but, clinical trial and all - there's still RISK! SUPER Hard to predict which would affect me and to what degree.

My onc. thinks I should try the clinical trial, saying Kadcyla is available if I need it, but the trial will be closed soon, it's an opportunity and the trial doc says she thinks it's good, etc. I feel like they are both trying to sell me a car.

I always thought I'd do KADCYLA next, but it is not without side effects, and again, don't know how it would affect me. The PROS are it's KADCYLA and stands a very good chance of working for me!! The CONS are my allergy to herceptin, which will mean pre-meds and a 6-7 hour infusion time for KADCYLA. Plus whatever the drug side effects.

There are no good answers, and I am having a hard time right now. The more pressure and judged I feel (by my doc, family, friends) the more depressed I become. The more I feel like I "should be more grateful" the more sad I feel. Every time I read of someone dying, it triggers grief, fear and anger. I'm a mess for someone who is supposed to be a pro at this game. I need to make a decision and none of it sounds good. At all.

What am I not seeing?!
Feel free to give opinions and advice...

NCT02965885 - clinical trial info, FYI:
Brief Summary:
A First-in-Human (FIH) study of TAS-116 in patients with advanced solid tumors was first initiated in Japan in April 2014 and has been ongoing since then. The study consists of a dose escalation phase and a dose expansion phase. Three dosing regimens of TAS-116, once daily (QD), every other day (QOD) and 5 days on/2 days off regimens in 21-day cycles, are being evaluated. This phase I study is also planned to enrol with advanced solid tumors in UK to confirm the MTD, safety, tolerability, and pharmacokinetics of TAS-116 in a Western patient population in the dose expansion phase. In addition, patients with HER2+ MBC, NSCLC harbouring EGFR mutations (EGFRT790M+) or EGFR mutations (T790M-) will be further evaluated for safety, tolerability and efficacy in 3 separate cohorts at recommended dose of TAS-116 on the 5 days on/2 days off regimen.