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Old 01-18-2008, 07:33 PM   #1
Lida
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Lapatinib With Anything Beside Xeloda?

Hi her-2 friends,
My onc was talking about perhaps putting me on Lapatinib with Gemzar or with Abraxane? She says it would be a "novel" combination -perhaps the cancer would be tricked by these new combos. Has anyone else tried lapatinib with chemo other than Xeloda? I really appreciate hearing from you. Lida
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Old 01-18-2008, 07:55 PM   #2
hutchibk
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what else have you been on? have you already had Xeloda? these are called "novel-strategies/therapies" in treatment of Her2 MBS - but I have heard that some folks run up against insurance issues if they don't follow the normal channels first (e.g. Tykerb w/Xeloda) , so if you haven't already had Xeloda, you might have trouble with coverage. I could be wrong, though.
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Brenda

NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."
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Old 01-18-2008, 08:11 PM   #3
Bill
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Hi Lida! My wife was the first to be on Lapatinib and Taxol in early clinical trials, along with Herceptin, and it worked well for her. Hope this helps, Bill
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Old 01-18-2008, 10:05 PM   #4
Lolly
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Hi Lida; I was on Abraxane with Tykerb for 4 months last year, and it worked well for 3 months but by the 4th month we had to change strategies again. However, I'm dealing with skin metastisis in the scar line and radiated tissue, and the chemo has a hard time getting to the cancer. It may work wonders for you, and certainly worth a try. I didn't experience too much in the way of side effects, a bit tired but my counts stayed steady. Had "Tykerb" rash and low grade fever but all in all very tolerable.
Insurance was a problem for me, as my ins. considered Tykerb a "specialty drug" and it was the highest tier of copay until I reached my max out-of-pocket, which took two months, then ins. paid all but 5%, so then it was ok. The fact that I was getting it with Abraxane instead of Xeloda wasn't an issue.
Good luck!

<3 Lolly
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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 01-19-2008, 03:42 PM   #5
Stephanie
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My mom is starting Taxol/Tykerb next week. She's on Medicare--don't think she's had any problems with insurance coverage other than that Medicare treats Tykerb as a prescription pill instead of a chemo drug, and she has to pay a very high percentage of it until she maxes out-of-pocket.
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Mother/daughter bc patients (should have signed up for spa treatments instead of chemo! Who knew?)

Mom:

dx 2002 age 62
Stage IIIB, triple positive
FACx6, tamoxifen
2004 Stage IV, started Herceptin
mets to pleura, lungs, bone
tried Arimedex, Faslodex, Zometa, Navelbine, Taxol, Taxotere, Gemzar, Carboplatin, Abraxane, Xeloda
June 2007 new mets to nodes and pericardiam
Switched from Xeloda/Herceptin to Xeloda/Tykerb
September 2007 Failed X/T. Switched back to Xeloda/Herceptin, added Gemzar
Jan 2008 Taxol/Tykerb
Feb 2008 Tykerb as a single agent

Me:

dx 2007 age 38
Stage IIA pleomorphic ILC ER/PR + HER2 -
FACx6, tamoxifen
Mom to 2, ages 6 and 9

Trying to find a new hobby besides going to the cancer center.
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Old 01-20-2008, 07:50 PM   #6
Vanessa
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I am on tykerb, herceptin and abraxane. I will be having a brain MRI and petscan next week, so I will probably know the results the week after. I was already on abraxane and herceptin when my doctor added the tykerb. I have not had any trouble having the insurance pay for it (knock on wood).
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Old 01-23-2008, 08:58 PM   #7
jones7676
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Posts: 606
Tykerb and Abraxane have worked wonders for me.....Pet scan results very positive - best I've had since moving to stage IV. Now hoping for good MRI of brain in March.
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Barb

10/03 Radical Mastectomy 3 cm tumor - 1/17 Nodes Stage II B, Her 2 +++ ER-/PR- 11/03 4 AC 4 Taxol 12/05 Stage IV - Lung met , Bone mets - Carbo, Taxotere, Herceptin 9/06 - 2 cm brain tumor 10/06 - Tumor removal surgery - Herceptin Halted 12/06 gamma knife tumor base.1/07 Navelbine/Herceptin 4/07 Rads to R femur 5/07 Stereotactic - new 2 cm brain tumor 4/07 Start Xeloda 5/07 Tykerb added 7/07 Brain MRI clean 10/07 .055 cm brain met found. 12/07 Stereotactic -1 cm brain tumor Start Tykerb 11/07 Abraxane/Herceptin 5/08 Cisplatin, Gemcitabine/Herceptin 6/08 Stereotactic to 1cm 9/08 Stereotactic repeat (growth). 11/08 Pet Scan Good but new tiny met on L lung/dead Brain surgery (no cancer cells found/scar tissue) 1/09 Chemo restarted 2/09 Pet Scan Bad - R larger very active/active L active lymph nodes both sides of chest MRI- mets slight increase 2/09 Start Doxil/Tykerb Treatment
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