Intrathecal (IT) Herceptin (Trastuzumab) for brain mets (Leptomeningeal Metastases)

[marvass]

My wife had a second stroke 5 weeks ago, but now recovery is going fast. She is close to start standing again. Understanding everything and communicating quite well.

Intrathecal herceptin is still on hold, only IV herceptin. Steroids are down to 2mg daily, with no fits recently.

She is doing physiotherapy, OT and speech therapy daily and hope to get her out from the rehab center by end of next month, to come home again after 4 months.

My advise is that intrathecal herceptin works but not on big lesions or a large edema. Radiation is needed on these before IT herceptin clears them completely. On 6 mm tumors IT herceptin works for sure but on a 2 cm edema it does not.

So any of you think that you can get away without doing radiation, think twice. The brain is such a delicate organ and you cannot risk to play with tumors in it for a long time. Strokes are a big risk to life besides that quality of life is reduced even after recovery.

My wife was advised to do radiation since October of last year but resisted it till 2 months ago. But I think it would have been much better if she did it before. 14 months with the edema in her brain were too long.

Mario