Gemzar or Taxol

[Adriana Mangus]

PLEASE I NEED YOUR OPINION, THIS IS SOMETHING I CANNOT DO ALONE.


Hi Everyone:

After almost five years since recurrence, I need to decide whether to add gemzar or a taxane to Herceptin. Please help!!!.

I have had navelbine+herceptin twice, navelbine has lost its effectiveness, Onc and I need to make a decision next year, after I obtained the CT chest scan results. He's not discouraged nor overly concerned about the latest CA 2729 # (45), he said that numbers fluctuate all the time. I do not like the number a bit. You probably have read my profile and have much more experience in dealing with this specific type of mets. Any help would be very much appreciated.
In reading the postings, I see that a lot of you have had either Taxol or Taxotere and have had excellent results. I read about Gemzar and it's also a very effective chemo (synergy) in combination with Herceptin.

Thanks so much for your help....Much love to all of you.

Adriana,

I can't help in your drug decision but I should mention that my 27-29 was 45 fifteen months ago but, after lots of scans, MRI, nothing was found. It went down to 37, then to 34, and now is 37 again. My oncologist, like yours, says there's nothing to worry about. And perhaps they're right, although it is difficult not to worry. Do you know what earlier numbers were? You may just have a higher than normal number.

[tousled1]

Adriana,

I can't offer you any advice on what you should do. I had taken Taxatere when I was first diagnosed and had good results with it. I'm currently on Taxol/Carboplatin and so far it appears to be working. I have no experience with Gemzar. I will keep you in my prayers.

[Jade]

I'm another one who has consistently high CA-153 (CA 27-29) results - they are always 37-40. My onc stresses that I shouldn't worry about this, that my 'normal' is at the high end of the range but it is normal because it is consistent. It's when the markers show a steady rise that there is cause for concern.
What I find unsettling is that the number actually went down to 27 while I was on chemo/herceptin, seemingly indicating the drugs were working, kicking cancer butt. So, what does it mean when the numbers climb back up to the high end of the range and remain there (15 months now)? Nothing, according to my onc. It's only when there's a steady increase that there's something going on. Adriana, I can't help with your drug decision either but I hope the tumour marker information will help.
Hope your day is happy,
Jade

[Mary Anne in TX]

Hi Adriana!
When I was first diagnosed, my onc asked me if I would give him permission to treat me very aggressively. I didn't really know what that meant, but I knew that inside the answer was yes. He layed out a plan of action with "other options" if something along the way didn't work. You can see by my signature what I did: Adriamycin & Taxotere X 3, Taxol, Carboplatin, Herceptin (dose dense) X 8. Navelbine & Herceptin (dose dense) X 8. And now just the Herceptin. Out beside the 2nd and 3rd cycles he had written Gemzar to be used if one of the others was not effective. And he had told me that when we got to the end of the first year, I could decide to add Xeloda if I felt I needed it. As I have read the information about the drugs over time, I have come to believe that for my situation, the choices were right on (I don't think we really know yet what is best....they're still trying to figure it out). The place I go for treatment does tons of phase I and II trials and is world reknown for the testing they do on drugs. I trust what advice I get there. But we have different needs and what I did seems to have worked for me (who knows!!!) but it's not an easy decision. Read tons about the drugs and just do your best in deciding.
Oh, yes, my tumor markers (CA 27-29) ranges in the 30s to upper 40's since an early 28. I believe that it indicates something being "held back" for now by herceptin, but that's just a "gut" feeling.
Well, obviously, I don't know what is best, I just want to support you in reading and asking and tell you I'll be praying about your decision. ma

Dear Jade,

I had a similar experience. Right after surgery, my number was 41+, a few days later it was 45. Then it went down, finally, after ten months of herceptin, to 34, and it's now up to 37. My HER2 serum was 16 and at end of herceptin was 8; still waiting for that result. My oncologist tells me the same as yours--you're at the high end of normal, and I know I should listen but there's always that lurking fear. Thanks for posting your number; your 15 months at the high end with nothing happening is encouraging. All my other blood results are the best I've had in 15 months, so as always fingers crossed. Oh, and I had exactly the same reaction when mine went down while on herceptin. If my normal is high end, why did it go down? But perhaps we assume more logic to this madness than actually exists.

Adriana--I hope that you also are at the high end of normal even in the best of times.

[jml]

Hi Adriana~
I'm on Gemzar + Herceptin, so far 2 cycles (4 doses) & it has worked like a dream, Thank God!
I had a couple of supraclavicular nodes that popped up, one of them last May, but stable until my most recent scans + a new one.
Even thoughTaxol + Herceptin has always been really effective knocking my disease back each time I've recurred, this time I decided to roll the dice, try Gemzar & save my hair!
Within the first treatment, my blood counts took a major hit, so much they werent sure if I could get my 2nd week treatment. More importantly, I felt a change in the nodes within days. With each dose, the nodes have melted away. I also broke out in a really gross rash, but nothing too dreadful. I'll probably do 1-2 more cycles before we scan again, but based on what we can/can't feel, Gemzar seems to be really doing the trick.
My schedule is Gemzar- 2 weeks on, 1 week off + Herceptin-q3week dose.
That means the I get my q3week Herceptin w/Week 1 Gemzar, Week 2 Gemzar solo, then the 3rd week is off.
It's nice to have atleast 1 week off.
I was apprehensive about trying something new, especially since Taxol worked so well for me in the past, and b/c navelbine didnt work at all when I first started, but I'm glad I took the chance.
I feel very, very fortunate!
If you choose this combo, I hope & pray you have equally as wonderful results.

Keep the Faith~

[SoCalGal]

Hi Adriana,

I was on carbo with gemzar. I did the gemzar alone every 2 weeks so I can say the side effects were not too bad.

I just saw John Glasby yesterday and he recommended that I try herceptin, avastin and tykerb. If I need to add in a chemo it will be navelbine so there you have it!
xoxo Wishing you well, Flori