Herceptin combined with chemo

I am in the middle of my chemo of 4x AC and then will be doing taxol. My onc is now going to give me Herceptin also. But my question is, what is better, Taxol with Herceptin at the same time or taxol by itself than Herceptin. He said the studies did both and there is no indication at this time what is better. any ideas?

[michele u]

Laurie,
They didn't give the difference between the arms yet. If i had the choice i would do them with the taxol. I took it a year after taxol.

It sounds from the recent news like there will be lots of news at ASCO, which ends May 17th. Can the decision wait until then? If not, I would go for herceptin at the same time, but be prepared to adjust to the news regarding the herceptin trials.

Thanks, I will be doing AC until the end of May. Hopefully we will know alot more after May 17.
Laurie

[Lolly]

My concern with doing the Herceptin with the Taxol would be having it so soon after A/C, which is now known to be the main reason some have developed heart problems from Herceptin use...maybe I'm wrong on this. Anyone else?

<3,
Lolly

[Rozebud]

Actually, Lolly, that's ok. The study design was to give herceptin and taxol immediately after A/C. Supposedly as long as they're not concurrent, you're ok. ???

It should be perfectly fine to receive Herceptin along with Taxol. My chemo mix has been Herceptin with Taxol and Carboplatin duirng my three months of neo-adjuvant chemo, and now I am in the middle of my second three months -- adjuvant chemo with the same three chemo drugs. They work very well together.

Here is a link to Taxol, which includes the possible side effects:
http://www.chemocare.com/bio/bio.sps?iBiographyID=9217

Just for kicks, here is the link to Carboplatin's info:
http://www.chemocare.com/bio/bio.sps?iBiographyID=7877

And finally, Herceptin:
http://www.chemocare.com/bio/bio.sps?iBiographyID=9160


Taxol doesn't carry much risk to the heart (in fact it's not mentioned in the list of Side Effects at all). Carboplatin carries come cardiac risks, but given as this triple combination to a health young patient, the risks are minimized. These drugs would not be given, for instance, to an older patient or someone presenting with other cardiac risks.

Good luck!
Val

According to the press release earlier this week, there is a 3-4% increased risk of heart problems when herceptin is added to the taxol part of this chemo, but a 52% reduction in the risk of recurrence over the first three years. All the data on herceptin at the same time as taxol vs. long-term herceptin later won't be known until ASCO, although there is a press conference today. (I have read that it's part of ASCO rules that they can't tell everyone everything before the conference).

[Lolly]

The 3-4% risk for heart problems that Christine quotes was the same statistic my onc quoted me when I started Herceptin/Navelbine in 2001, which was almost 1 year after finishing primary tx, which was ACT. So looks like the risk is about the same across the board unless Herceptin is given with or immediatly after AC. Maybe some more data will come out before ASCO since this is such a "hot button" issue!

<3,
Lolly

[Lolly]

Oops, didn't mean to keep harping on Herceptin risk immediatly after AC, I think Roze is correct in that as long as they're not concurrent it should be ok.

<3,
Lolly

The cardio risks associated with herceptin are miniscule compared to the risks of not getting herceptin at all. Everything has to be put in perspective.
Regards,
Al

Laurie:

I agree with Al. I was diagnosed as 2B, a 3.5 cm tumor with one positive node and lymphovascular invasion in January 2004. I had dose dense A/C and Taxol. I have had Herceptin off label for almost a year and have asked my oncolgist for a second year. I had mild hypertension and some mitral value regurgitation before Herceptin and my most recent heart tests indicate that there has been no change. I believe that Herceptin is worth the risk.

Barbara

[Lolly]

I agree that Herceptin is well worth the risk, but I believe one should be aware of all known aspects.

<3,
Lolly

Hi Lolly: You are correct to mention the possibility of heart damage. I was also in the trial that has just been stopped but I was one of the people that did have significant heart damage and had to stop taking Herceptin. I recieved the standard 4 AC treatments without Herceptin and then 4 Paclitaxol/ Herceptin treatments. My heart function went from close to 80% (which is very good) to the 50's (which is average) in the space of 3 months. The people that were running the trial were afraid to let me take anymore Herceptin and compromise my quality of life even though I begged them to let me continue the Herceptin...I am Stage III, 10 positive nodes, 3 primary tumors (lots of disease and a prime canidate for progression). Fortunatly, after I had been off Herceptin for 8 weeks my heart function returned to close to it's previous level. I think that they have discovered that it IS possible to give yourself a "rest" and then continue the Herceptin. My Oncs. opinion was that he felt the best benifit from Herceptin was when it was given in conjunction with the Paclitaxol. He felt that the Herceptin made the chemo more effective. Who knows if he is right. At this point I am NED but I think I will give him a call on Monday and see what he has to say about starting the Herceptin again. Take Care, Linda in Calif.

I am a "newbie" here. I just returned from MDAnderson yesterday and was discussing Herceptin w/ my Onc there. I've already received AC X4 and have started Taxol,so I have "missed the boat". She advised at this point to wait until ASCO to make a final decision.
Her2neu 3+ ,stage IIB T2N1

I hope I am posting in the right forum!

Dear Soccermom,
You're in the right place; welcome!
There's lots to learn here.
Regards,
Al

Hi, from my experience I would be going more is better. I had Herceptin/carboplatin and my BC stalled, no bigger no smaller then when we added Taxol 26 weekly doses it just about got it all, large lymph in neck but mine then went to skin mets in the other remaining breast and I have just finished 23 doses of radiation with Xeloda and on paper I am normal but will have to do punch biopsy when the radiated area is back to normal, so I am wait and see. Hope this helps. I had AC back in 1998 with radiation and then day1 day 8 CMF and after that I had Femara, Taxotere, Xeloda, Herceptin, Herceptin Carboplatin then added Taxol and now come off Herceptin/Xeloda and just on Herceptin for now. I have been doing this since 1998 so I wish we new then what we knew now and could cut to the chase and go straight for the Herceptin Taxol Carboplatin. Hope this helps

Love & Hugs Lyn