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Old 11-28-2006, 04:52 PM   #1
John21
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Cool Experimental or not

Hi everyone,

Does any one know if the combination of Taxol, Carboplatin and Herceptin treatment is classified experimental or I guess approved? Having insurance probelems. They cover Herceptin alone, but not as a combo treatment. WHat gets me is that she would of took it alone afterwards anyhow!
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Old 11-28-2006, 06:22 PM   #2
Stephanie
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My mom was on taxol/carbo/herceptin. It was not considered experimental, but she's stage IV, so maybe it's considered experimental if there are no mets?
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Old 11-28-2006, 08:09 PM   #3
Sandy H
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I am stage 3b, IBC, and I took the same combo a few times. You can see in my signature. It was not experimental for me. I only had skin mets. You may need to keep after them to pay. Your doctor should be able to help or a social worker at the hospital. hugs, Sandy
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Dx. 03/01, Rt. IBC
AC/Taxatere
Rt. MRM-with graft Lt. simple
5 rads-skin mets
Herceptin, taxol, carboplatin (taxol seem to be the magic drug)
Navelbine & xeloda (did not work)
topical miltex for skin mets
Tykerb/xeloda
thoracentesis x 2 left lung fluid shows cancer cells
Port removal (4 years) with power port replacement
Doxil
Updated 05-07 Scans show no bone or organ involvement we shall see!




I shall not pass this way again. Any good I can do or any kindness that I can show let me not defer or neglect it for I shall not pass this way again.
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Old 11-28-2006, 08:28 PM   #4
chrisy
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I took that exact same combo
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June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?"
9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++
10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!
04/05 - 4/07 Herception every 3 wks, Continue NED
04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial
06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin
01/08 Progression in liver
02/08 Begin (TDM1) trial
08/08 NED! It's Working! Continue on TDM1
02/09 Continue NED
02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED
12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver
07/11 - 11/11 Herceptin/Xeloda -not working:(
12/11 Begin MM302 Phase I trial - bust:(
03/12 3rd times the charm? AKT trial

5/12 Scan shows reduction! 7/12 More reduction!!!!
8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!)
9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3
11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc
11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go.
2/13 Gemzar/Carbo/Herceptin - no go.
3/13 TACE procedure
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Old 11-28-2006, 08:47 PM   #5
Lolly
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John, I know several who have had that exact combo also. Here's a link to FDA approved drugs, along with the year in which they were approved. All three of these are FDA approved, and so the insurance should not be able to dictate to your onc how to administer those drugs, whether alone OR in combo.

FDA Approved Drugs
http://dtp.nci.nih.gov/timeline/noflash/FDA.htm
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Sept.'99 - Dx.Stage IIIB, IDC ER/PR-, HER2+++ by IHC, confirmed '04 by FISH. Left MRM, AC x's 4, Taxol x's 4, 33 Rads, finishing Tx May 2000. Jan.'01 - local/regional recurrence, Stage IV. Herceptin/Navelbine weekly till NED August 2001, then maintenance Herceptin. Right Mast. April 2002. Local/Regional recurrence April '04, Herceptin plus/minus chemo until May '07. Gemzar added from Feb.'07-April '07; Tykerb/Abraxane until August '07, back on Herceptin plus Taxotere and Xeloda Sept. '07. Stopped T/X Nov. '07, stopped Herceptin Dec. '07, started Avastin/Taxol/Carboplatin Dec. '07. Progression in chest skin, stopped TAC March '03, started radiation.

Herceptin has served as the "Backbone" of my treatment strategy for over 6 years, giving me great quality of life. In 2005, I was privileged to participate in the University of Washington/Seattle HER2 Vaccine Trial.
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Old 11-28-2006, 10:18 PM   #6
Bev
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Hi, Make a complaint to your state insurance board, in writing. Have your onc write a paragraph why this is the optimum treatment. They'll come around. BB
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Old 11-28-2006, 10:26 PM   #7
Sherryg683
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John, who in the world is your insurance with. Herceptin alone is what they approve? Herceptin is being used in many combinations now, they need to come up to date with what they approve...sherryg683
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Old 11-29-2006, 06:41 AM   #8
John21
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Thanks all. Just needed some reassuring. We have good insurance. I maybe just think they are trying loopholes. As you know, it is not cheap for this stuff. We are still working with our company. Just does not make any sense.
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Old 11-29-2006, 09:02 AM   #9
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The HER2 Support Group is planning to host a teleconference in February on legal and insurance issues. Look for the announcement soon.

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Old 11-29-2006, 10:43 PM   #10
jhandley
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Carbo/taxol/herceptin

Hi John
Initial studies showed this combo increased time to progession compared to taxol/herceptin (17 mnths vs.9 mnths) however my onc told me last week that latest trial results show that it did not have an impact on overall survival time. I wanted to include it in my treatment but didnt get it as herceptin is/was only approved in Australia with taxol.
jackie
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Old 11-30-2006, 04:43 AM   #11
Lani
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rare commodities

taxol is made from the bark of a rare yew tree

carboplatin from platinum salts I believe

and we all know how expensive Herceptin is

I think insurance companies cringe at paying for any of these three individually--so they really squirm when all three are prescribed.

Many insurance contracts say there must be published guidelines from a recognized oncology association advocating a treatment--I don't know how/if they get away with this and if they can do it with a combination rather than an individual drug.

We are all hoping for individualized treatment of cancer--yet insurance companies seem to be getting in the way of progress by wishing to only pay for "cookbook medicine" ie, you get the same one from Column A and one from Column B even if there is a reason for "substitutions"eg kidney or liver failure, heart disease, etc.

Best of luck in your fight!!!
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Old 11-30-2006, 09:51 PM   #12
Lolly
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John, they're apparently trying to split hairs; Herceptin is FDA approved in combo with certain chemo's, although not the exact combo your onc is proposing.
Here's Genentech's press release on FDA approval for Herceptin/chemotherapy combo's:
http://www.gene.com/gene/news/press-...etail&id=10207

and here's a link to a report on a clinical trial using the Taxol, Carboplatin and Herceptin combo:
http://www.ufscc.ufl.edu/Patient/can...rnews&id=37452

So given that this combo is in clinical trials and not FDA approved, they may be able to deny it.
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Sept.'99 - Dx.Stage IIIB, IDC ER/PR-, HER2+++ by IHC, confirmed '04 by FISH. Left MRM, AC x's 4, Taxol x's 4, 33 Rads, finishing Tx May 2000. Jan.'01 - local/regional recurrence, Stage IV. Herceptin/Navelbine weekly till NED August 2001, then maintenance Herceptin. Right Mast. April 2002. Local/Regional recurrence April '04, Herceptin plus/minus chemo until May '07. Gemzar added from Feb.'07-April '07; Tykerb/Abraxane until August '07, back on Herceptin plus Taxotere and Xeloda Sept. '07. Stopped T/X Nov. '07, stopped Herceptin Dec. '07, started Avastin/Taxol/Carboplatin Dec. '07. Progression in chest skin, stopped TAC March '03, started radiation.

Herceptin has served as the "Backbone" of my treatment strategy for over 6 years, giving me great quality of life. In 2005, I was privileged to participate in the University of Washington/Seattle HER2 Vaccine Trial.
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Old 12-01-2006, 11:15 AM   #13
Alice
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Hi John,

I had that combo as a clinical trial. The only reason it was concidered a trial was I was not stage 4. Keep fighting for your insurance. It was a tough combo but it was worth it.
Good luck, Alice
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