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Re: Kadcyla/TDM1 CELEBRATION @ Genentech:)
Coolbreeze,
I don't know a lot about this but it's unclear to me about your treatment center not being able to afford T-DM1. I'm under the impression that the $9,000 bill is what centers will bill to insurance and that the carrier will pay the contracted rate. However, your treatment center doesn't pay that per treatment, but only a fraction of that. Otherwise how would anybody earn revenue? Afterward, they make back the money and then some through your insurance company. Perhaps this is related to what your insurance company would pay. Maybe you should dig deeper into the costs for the parties involved.
Also, this doesn't seem to be a case like Peter Bach and Leonard Saltz at Sloan-Kettering who refused to bring Sanofi's Zaltrap into Memorial for colorectal cancer. The drug is the same as Avastin, but the drug company was charging Memorial double the amount. The problem was that the clinical trial was designed as a non-inferiorty trial, which muddied the water, and of course the powers that be at Memorial aren't easily fooled by big pharma.
I just noticed in your signature that you don't seem to be taking Herceptin. Is there a reason for that? Oncs have now known for several years that women with metastatic breast cancer whose cancer advances while on Herceptin and a chemo still do better when they keep taking Herceptin, regardless of advancing. This is a known fact, so I'm surprised that you're not taking it. That was my point in another thread about T-DM1. Not that T-DM1 is not a good drug. It is. But it was compared to a regimen (capecitabine and lapatnib, or Xeloda and Tykerb) that no onc in their right mind would ever prescribe today -- without Herceptin. If it had been combined with a Herceptin combo it undoubtedly would not have had such stellar results, even though it still might have improved PFS and OS. But now that Genentech has gotten the approval, we'll see what happens with MARIANNE.
If it were me I would ask my onc about Herceptin and ask more questions about why they can't afford T-DM1.
Best,
Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
Last edited by Joan M; 03-02-2013 at 09:26 AM..
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