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Old 12-28-2006, 11:56 PM   #1
Sherryg683
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Tykerb w/Herceptin while in remission dilema

I was talking with my Oncologist today and he said he thinks Tykerb will be approved by the end of the month, I read Christina's post about it being in February. I have read in "Cure" magazine about Tykerb being used with Herceptin and how they think it would be very effective. I am Stage IV but have been NED for 8 months now, I take Herceptin weekly pretty much till it quits working. My dilema is I am really wanting to get on Tykerb with HErceptin to help prevent reoccurance. But I am also wondering about should I save Tykerb for the day (if and when) Herceptin does quit working for me. I wouldn't want to form an early immunity to it, does this make sense? Is anyone else here in the same situation as me and have you discussed this with your Oncologist and if so, what did they say. I asked my Oncologist if he thought it would be beneficial to me to get on both and he said he really didn't know the answer to that..he's pretty honest He has brought up both points that I made. I really like the idea of Tykerb crossing the BBB and protecting the brain. I also think that if the combination of both will keep me disease free for more years, there may be something else that will be developed in the meantime... What are your opinions on the subject and what are you gals planning on doing? ..sherryg683
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Old 12-29-2006, 01:59 AM   #2
jhandley
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Me too

Hi Sherry
I have been on herceptin and in remission for 15 months.. I would like to go onto Tykerb as well when it eventually becomes available. I think both are better and then if further problems arise there may be other options available as time goes on.

Cheers
Jackie
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Old 12-29-2006, 08:50 AM   #3
Mary Anne in TX
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I'd like to do the same thing you're talking about!

Seems like prevention is better than fix it!
What I've read on line indicates that they really don't know the answer.
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MA in TX.
Grateful for each and every day....

Diag. 12/05 at age 60
Stage II, Grade 3, 4.5 cm primary tumor
ER/PR- Her2 +3 strongly positive
Her2 by FISH 7.7 amplified
vascular invasion
Ki67 20% borderline
Jan - March '06 Taxotere/Adriamycin X 3 to try to shrink tumor - it grew
April '06 Rt Modified Radical Mas, 7 of 9 nodes positive
April - Aug. '06 Herceptin/Taxol/Carboplatin X 8 (dose dense)
Sept - Dec. '06 Navelbine/Herceptin x 8 (dose dense)
Radiation & Herceptin Jan. 22 - March 1, 2007
Finished Herceptin Dec. 10 '08! One extra year.
Port removed August, 2012.
8 1/2 years since diagnosis! 5 1/2 Years NED!
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Old 12-29-2006, 09:14 AM   #4
KellyA
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My oncologist and I have been talking about the same thing. I am a stage 2b, but really want to do whatever I can to prevent recurrance (sp?). He is willing to give it to me off label. I have similar questions- 1. can it be taken with Herceptin safely, as I will only be 1/2 way through my "year" of Herceptin and 2. I am afraid of using it now and then it not being effective later if I need it.
I really like the fact that it crosses the BBB and might give me some added protection.

Love, Kelly
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dx'd 05/06, 37 years old
er/pr-, Her2+, grade 3
double mastectomy, immediate reconstruction- implants
Stage 2b, 2 tumors- 2.2 cm and 0.6 cm, 3/5 + nodes
all scans clear
genetic testing- negative
06/06 began dd A/C x 4, 12 weekly Taxols w/ Herceptin
30 rads
Herceptin weekly x 1 year
Herceptin completed 08/07
Port removed 12/26/07 MERRY CHRISTMAS!!!!!!
05/17/08 Two year anniversary NED

"We gain strength, courage, and confidence by each experience in which we really stop to look fear in the face... you must do the thing that you think you cannot do."

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Old 12-29-2006, 03:50 PM   #5
JerseyGirl
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Sherry, I'm in the same boat. I'm stage IV, been NED for only 4 months, but am already thinking about Tykerb; I'm on Herceptin indefinitely. My personal opinion is the more protection the better and I haven't heard about too many side effects on Tykerb, except some women have terrible diaherra (sp?). Not sure of the percentage that are affected. I'll ask my onc about it at my next appt on the 8th. My feeling is he'll want to save it for if the Herceptin ever stops working. I'll let you know what he says.
Julie
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Old 12-29-2006, 04:29 PM   #6
Adriana Mangus
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Tykerb + Herceptin

Hi Sherry: My onc. won't put me on Tykerb. Reason: I'm a first line chemo patient. He feels that I should try everything that's available for me before trying the "latest" discoveries. In short, he said that we don't start from the end; rather from the beginning, does it make any sense to you? I will be seeing him Jan. 9, am planning on asking him again about the above combo. I'll keep you posted...
__________________
1994 - rt brst, .lump, underarm node dissection,chemo+rad 1.2 cms, Grade 3.
28 nodes neg
Er,Pr, Positive HER2 status unknown
2003- Recur to rt lung.July 16 ( B-Day!)
Her2+++ Er,Pr, Negative
2003 - Aug04--Navelbine + Herceptin
2004- 2007--
NED - Herceptin, only
2007 Feb-April Xeloda added to hereceptin
2007-May Back on Navelbine+Herceptin
2008-Feb-Mar 15 Ses Rad to Rt. Lung
2008- Oc 17 Add Tykerb to Herceptin
2009- June-- Discont Tykerb
2009 July 7--Current Taxol + Herceptin
2009 Dec--Discontinued treatment due to progression. Looking into cyberknife.
2010-Aug Accepted to TDM1, no SE, except liver count went up.
2010-2011 September got kicked out of the trial, due to a small spot found on lung.
2011- 2012 September thru early 2013 on Herceptin
2013- March Bone density shows small spot on 5th rib.
2013 - April 4th appt with onc. will post after discussing course of treatment.
2013-March-April Cyber knife to brain and radiation to rib. Chest --base line before chemo-CT-Scan stable for lung issue. CA2729 Normal.
2013 April Herceptin- TDMI
2013 Sept Herceptin + Perjeta . CA2729 within normal range. Brain and Pet scans October 31st. will post results.
2013 October Brain MRI- mixed response. Will see Onc/rad on Halloween.
2013 October/November Brain-MRI nothing new. Repeat MRI next year in May.

2013 December Continue Herceptin and Perjeta. Stable at the moment.
2014 February Brain MRI -clear!
2014 January Added Taxotere to Perjeta+Herceptin.
2014 March Stopped chemo-chest ct-scan next.

2014- March Scans shows tumor's larger, CA2729 higher. Discontinue Herceptin.
2014 April Perjeta+ Halaven
2014 April CA2729 went down 60 points after one cycle. Cough does not want to go away.
2014 June Continue on Perjeta + Halaven-- no more cough. Stable
2014 June Back on Herceptin + abraxane
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Old 12-29-2006, 05:06 PM   #7
CLTann
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Andriana:

Your onc's explanation does not make scientific sense. If he is correct, then all treatments must go back to the primitive time, including those voodoo superstitions, for all ailments. When new effective medicines are available, we should take advantage of the discovery and go with them. Find another doctor and compare their advices. Although my situation is totally different from yours, I just want to point out the logic behind these advices.
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Stage 1 dx Sept 05
ER/PR positive HER2 +++ Grade 3
Invasive carcinoma 1 cm, no node involvement
Mastec Sept 05
Annual scans all negative, Oct 06
Postmenopause. Arimidex only since Sept 06, bone or muscle ache after 3 month
Off Arimidex, change to Femara 1/12-07, ache stopped
Sept 07 all tests negative, pass 2 year mark
Feb 08 continue doing well.
Sep 09 four year NED still on Femara.
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Old 12-29-2006, 08:29 PM   #8
Sherryg683
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That was sort of what I was wondering about, if I take Tykerb while I am in remission, would I develope a resistance to it, if I may ever need it later. But then again, I am hoping to stay in remission and not need it later..and I figure the Tykerb would help there. I was on Taxotere, Xeloda and Herceptin for 4 months and after about 6 weeks on those drugs my lung mets were gone, so I know we could always go back to that. Then again, I am so worried about brain mets and if Tykerb helps protect against that, then I can't see not taking advantage of that. I figure the way things are going, they are sure to develop new drugs in the near future that might even be better. I just remember reading that article in "Cure" that I spoke of and it saying how they think Tykerb with Herceptin would be the one/two knockout that may be needed for HER2+. Since one attacks the outside of the cell and the other attacks the inside. I think I am going to get on it as soon as it's available and stay on the Herceptin also. My Oncologist will do whatever I want. I read someone saying they were going to get on Tykerb "off label". What exactly does that mean? If it is approved by February would you still need to get it off label? My Oncologist told me that he has several women who are on Tykerb right now and all of them have been responding to it, he said it was amazing what he has seen. He said the only side effect that he has seen so far is that it makes the biliruben (sp?) in the blood go higher, but the patients haven't noticed anything. ..sherryg683
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Old 12-29-2006, 10:33 PM   #9
Vanessa
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The last time I talked with my doctor, she is of the opinion to stay on the same treatment until you become resistant and then go from there, so I have a feeling she will save Tykerb for later. There is a possibility she will change her mind about that as new information becomes available. However, I am thinking I don't want to exhaust my possibilities early on. I am kind of confused about that, also. I am glad to know that Tykerb is having amazing results!
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Old 12-30-2006, 08:56 PM   #10
Adriana Mangus
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Confused

I don't know what to do know? Seems life half of the respondents are inclined to stay on the drug that's currently working for you, then wait until resistance becames apparent> Then what's next Tykerb? or another drug, I have metastasis to rt lung, navelbine + herceptin did the work for 3 1/2 years, will begin xeloda next month. After I develop resistance to this combo, should I start Tykerb? Another drug? So many questions....?? I will definitely ask my onc. next month, am also inclined to see someone else and compare opinions. What do you think?
__________________
1994 - rt brst, .lump, underarm node dissection,chemo+rad 1.2 cms, Grade 3.
28 nodes neg
Er,Pr, Positive HER2 status unknown
2003- Recur to rt lung.July 16 ( B-Day!)
Her2+++ Er,Pr, Negative
2003 - Aug04--Navelbine + Herceptin
2004- 2007--
NED - Herceptin, only
2007 Feb-April Xeloda added to hereceptin
2007-May Back on Navelbine+Herceptin
2008-Feb-Mar 15 Ses Rad to Rt. Lung
2008- Oc 17 Add Tykerb to Herceptin
2009- June-- Discont Tykerb
2009 July 7--Current Taxol + Herceptin
2009 Dec--Discontinued treatment due to progression. Looking into cyberknife.
2010-Aug Accepted to TDM1, no SE, except liver count went up.
2010-2011 September got kicked out of the trial, due to a small spot found on lung.
2011- 2012 September thru early 2013 on Herceptin
2013- March Bone density shows small spot on 5th rib.
2013 - April 4th appt with onc. will post after discussing course of treatment.
2013-March-April Cyber knife to brain and radiation to rib. Chest --base line before chemo-CT-Scan stable for lung issue. CA2729 Normal.
2013 April Herceptin- TDMI
2013 Sept Herceptin + Perjeta . CA2729 within normal range. Brain and Pet scans October 31st. will post results.
2013 October Brain MRI- mixed response. Will see Onc/rad on Halloween.
2013 October/November Brain-MRI nothing new. Repeat MRI next year in May.

2013 December Continue Herceptin and Perjeta. Stable at the moment.
2014 February Brain MRI -clear!
2014 January Added Taxotere to Perjeta+Herceptin.
2014 March Stopped chemo-chest ct-scan next.

2014- March Scans shows tumor's larger, CA2729 higher. Discontinue Herceptin.
2014 April Perjeta+ Halaven
2014 April CA2729 went down 60 points after one cycle. Cough does not want to go away.
2014 June Continue on Perjeta + Halaven-- no more cough. Stable
2014 June Back on Herceptin + abraxane
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Old 01-08-2007, 04:25 PM   #11
Adriana Mangus
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HI Vanessa: Hope all's well with you. Congratulations on you NED!!! Awesome!!!. It's incredible what these new drugs con do for us. Stay positive..How long ago did you have bc. WHen did it metastasized. I have mets to rt lung. I have been so apprehensive, do not know what to do; if start tykerb when available or try other drugs until I became resistant to those drugs...Any advice? Thank you.
__________________
1994 - rt brst, .lump, underarm node dissection,chemo+rad 1.2 cms, Grade 3.
28 nodes neg
Er,Pr, Positive HER2 status unknown
2003- Recur to rt lung.July 16 ( B-Day!)
Her2+++ Er,Pr, Negative
2003 - Aug04--Navelbine + Herceptin
2004- 2007--
NED - Herceptin, only
2007 Feb-April Xeloda added to hereceptin
2007-May Back on Navelbine+Herceptin
2008-Feb-Mar 15 Ses Rad to Rt. Lung
2008- Oc 17 Add Tykerb to Herceptin
2009- June-- Discont Tykerb
2009 July 7--Current Taxol + Herceptin
2009 Dec--Discontinued treatment due to progression. Looking into cyberknife.
2010-Aug Accepted to TDM1, no SE, except liver count went up.
2010-2011 September got kicked out of the trial, due to a small spot found on lung.
2011- 2012 September thru early 2013 on Herceptin
2013- March Bone density shows small spot on 5th rib.
2013 - April 4th appt with onc. will post after discussing course of treatment.
2013-March-April Cyber knife to brain and radiation to rib. Chest --base line before chemo-CT-Scan stable for lung issue. CA2729 Normal.
2013 April Herceptin- TDMI
2013 Sept Herceptin + Perjeta . CA2729 within normal range. Brain and Pet scans October 31st. will post results.
2013 October Brain MRI- mixed response. Will see Onc/rad on Halloween.
2013 October/November Brain-MRI nothing new. Repeat MRI next year in May.

2013 December Continue Herceptin and Perjeta. Stable at the moment.
2014 February Brain MRI -clear!
2014 January Added Taxotere to Perjeta+Herceptin.
2014 March Stopped chemo-chest ct-scan next.

2014- March Scans shows tumor's larger, CA2729 higher. Discontinue Herceptin.
2014 April Perjeta+ Halaven
2014 April CA2729 went down 60 points after one cycle. Cough does not want to go away.
2014 June Continue on Perjeta + Halaven-- no more cough. Stable
2014 June Back on Herceptin + abraxane
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Old 01-08-2007, 05:55 PM   #12
Hopeful
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KellyA,

I am of a similar mind as you. I am stage 1, ER+/PR+, currently on Heceptin + Arimidex. Since none of us stage I-III patients can tell if Herceptin is working for us if we are NED, I am concerned that I may fall in the "doesn't work" category, and don't want to wait to be Stage IV to find out. Also, I am concerned that the combination of the AI and Herceptin is not adequate to block all the "cross talk" pathways there may be, and that the cancer may become adapted to very low levels of estrogen and begin to grow again. In the current Breast Cancer Update, Dr. Chang discusses a laboratory experiment that combined Herceptin, Tykerb and an AI, which killed 100% of the cancer cells. It seems that most of the discussion of the primary value of this drug for early stagers will be as another synergistic combination with Herceptin, rather than in lieu of. I am going to continue to discuss this option with my onc when I see him for Herceptin treatments.

Hopeful
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