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Old 01-03-2009, 11:14 AM   #1
turbo
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advice on herceptin/xeloda combo/

I will be going off a phase 1 trial of Tykerb escalated dose . I have done well on tykerb for almost 2 years...stable(first 16 mo. w/avastin) Any progression in phase one means need to go off and I showed a couple centimeter progression. The next plan is xeloda /herceptin(every 3 weeks) I have been stage 1V for 2 years and never on herceptin . I have a couple small lung nodules. have not altered any activity due to treatments so far..any advice on new combo? Thanks!
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Old 01-09-2009, 05:34 PM   #2
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sorry to report turbo, but i've had horrendous problems with these drugs. did go to er new years day and was just released yesterday. very frightening and difficult week. pancreatic tests were normal this time, liver and bilirubin very high. was jaundiced. so this time it wasn't pancreatitis, but after more testing turned out to be blocked bile duct so i was very sick. had a horrible procedure (without a general) to insert 2 stents in bile ducts with a drain. they removed 30 cc of bile. that night spiked 103 temp so they called in infect. dis. doc. then had trouble breathing and have partial collapsed lung on right side. they had to put a tube with the stents completely thru my liver and thread thru ducts to main duct. it wasn't pretty...horribly painful. next morning went back to be sure bile was draining and then removed the drain. finally home yesterday still in lots of pain but will be having visiting nurse for a while. so needless to say these 2 drugs are gone for good. onc said will have rads to the nodes in belly that have mets and then will try other chemo. i think she said avastin and taxol. not 100% on the avastin. this has been going on since early sept when i started these drugs. i know many are on xeloda without the problems i've had. as far as the combo, i don't think that many ladies are on both since herceptin is very effective. i certainly pray your experience will not only be effective but much much easier than mine has been. please feel free to send me any questions you might have, (that is if i haven't completely scared you off). my prayers are with you. grandma
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Old 01-09-2009, 06:05 PM   #3
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So sorry to hear about your bad experience...one never knows for sure what their experience will be. My Inc seems to think I won 't have a hard time as I have not had other common side effects with previous treatments. Good luck with avastin, I did well with that. Just curious what dose you were on with xeloda?thanks
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Old 01-10-2009, 04:55 PM   #4
grandma2
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with xeloda i started on 8 pills daily, then went to 4 pills daily, and finally 2 pills daily. tykerb was supposed to be 5 pills daily but i took 4/day. docs are not sure if it was one or the other or a combo. i'm wondering why you stopped avastin. good luck.
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Old 01-11-2009, 02:15 PM   #5
yankeebikachic
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I have not been on that combo but am having great results with tykerb/xeloda. I take 6 pills a day of xeloda (my doc told me that is max dose and then some for my body weight) and 5 of tykerb every day. Lots of women have had great results with xeloda and H, go for it, its well worth it to beat this disease back down. I do have side effects, rash on face, hand/foot syndrome, increased bilirubin and upset tummy with loose bm's. I know, it doesn't sound like fun! But I am doing well, NED and working long hours, standing on my feet with a very active lifestyle.
Good luck to you.
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Old 01-15-2009, 12:39 AM   #6
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Thanks ...sounds encouraging!
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Old 01-16-2009, 11:42 PM   #7
SoCalGal
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Herceptin tykerb would also be good. I wish more oncs would ADD them together and evaluate. Xeloda in the mix is good for "synergy" I suppose but it would be nice to see if you respond on "just" herceptin before you add in the xeloda. Is that too risky? I was on herceptin/tykerb and then added in avastin and it seemed to make me stable. It's so hard to choose. --Flori
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1996 cancer WTF?! 1.3 cm lumpectomy Er/Pr neg. Her2+ (20nodes NEGATIVE) did CMF + rads. NED.
2002 recurrence. Bilateral mastectomy w/TFL autologous recon. Then ACx2. Skin lymphatic rash. Taxotere w/Herceptin x4. Herceptin/Xeloda. Finally stops spreading.
2003 - Back to surgery, remove skin mets, and will have surgery one week later when pathology can confirm margins.
‘03 latisimus dorsi flap to remove skin mets. CLEAN MARGINS. Continue single agent Herceptin thru 4/04. NED.
‘04 '05 & 06 tiny recurrences - scar line. surgery to cut out. NED each time.
1/2006 Rads again, to scar line. NED.

3/07 Heartbreaking news - mets! lungs.sternum. Try Tykerb/Xeloda. Tykerb/Carbo/Gemzar. Switch Oncs.
12/07 Herceptin.Tykerb. Markers go stable.
2/8/08 gamma knife 13mm stupid brain met.
3/08 Herceptin/tykerb/avastin/zometa.
3/09 brain NED. Lungs STABLE.
4/09 attack sternum (10 daysPHOTONS.5 days ELECTRONS)
9/09 MARKERS normal!
3/10 PET/CT=manubrium intensely metabolically active but stable. NEDhead.
Wash out 5/10 for tdm1 but 6/10 CT STABLE, PET improving. Markers normal. Brain NED. Resume just Herceptin plus ZOMETA
Dec 2010 Brain NED, lungs/sternum stable. markers normal.
MAR 2011 stop Herceptin/allergy! Go back on Tykerb and switch to Xgeva.
May-Aug 2011 Tykerb Herceptin Xgeva.
Sept 2011 Tykerb, Herceptin, Zometa, Avastin.
April 2012 sketchy drug trial in NYC. 6 weeks later I’m NED!
OCT 2012 PET/CT shows a bunch of freakin’ progression. Back to LA and Herceptin.avastin.zometa.
12/20/12 add in PERJETA!
March 2013 – 5 YEARS POST continue HAPZ
APRIL 2013 - 6 yrs stage 4. "FAILED" PETscan on 4/2/13
May 2013: rePetted - improvement in lungs, left adrenal stable, right 6th rib inactive, (must be PERJETA avastin) sternum and L1 fruckin'worsen. Drop zometa. ADD Xgeva. Doc says get rads consultant for L1 and possible biopsy of L1. I say, no thanks, doc. Lets see what xgeva brings to the table first. It's summer.
June-August 2013HAPX Herceptin Avastin Perjeta xgeva.
Sept - now - on chemo hold for calming tummy we hope. Markers stable for 2 months.
Nov 2013 - Herceptin-Perjeta-Avastin-Xgeva (collageneous colitis, which explains tummy probs, added Entocort)
December '13 BRAIN MRI ned in da head.
Jan 2014: CONTINUING on HAPX…
FEB 2014 PetCT clinical “impression”: 1. newbie nodule - SUV 1.5 right apical nodule, mildly hypermetabolic “suggestive” of worsening neoplastic lesion. 2. moderate worsening of the sternum – SUV 5.6 from 3.8
3. increasing sclerosis & decreasing activity of L1 met “suggests” mild healing. (SUV 9.4 v 12.1 in May ‘13)
4. scattered lung nodules, up to 5mm in size = stable, no increased activity
5. other small scattered sclerotic lesions, one in right iliac and one in thoracic vertebral body similar in appearance to L1 without PET activity and not clearly pathologic
APRIL 2014 - 6 YRS POST GAMMA ZAP, 7 YRS MBC & 18 YEARS FROM ORIGINAL DX!
October 2014: hold avastin, continue HPX
Feb 2015 Cancer you lost. NEDHEAD 7 years post gamma zap miracle, 8 years ST4, +19 yrs original diagnosis.
Continue HPX. Adding back Avastin
Nov 2015 pet/ct is mixed result. L1 SUV is worse. Continue Herceptin/avastin/xgeva. Might revisit Perjeta for L1. Meantime going for rads consult for L1
December 2015 - brain stable. Continue Herceptin, Perjeta, Avastin and xgeva.
Jan 2016: 5 days, 20 grays, Rads to L1 and continue on HAPX. I’m trying to "save" TDM1 for next line. Hope the rads work to quiet L1. Sciatic pain extraordinaire :((
Markers drop post rads.
2/24/16 HAP plus X - markers are down
SCIATIC PAIN DEAL BREAKER.
3/23/16 Laminectomy w/coflex implant L4/5. NO MORE SCIATIC PAIN!!! Healing.
APRIL 2016 - 9 YRS MBC
July 2016 - continue HAP plus Xgeva.
DEC 2016 - PETCT: mets to sternum, lungs, L1 still about the same in size and PET activity. Markers not bad. Not making changes if I don't need to. Herceptin/Perjeta/Avastin/Xgeva
APRIL 2017 10 YEARS MBC
December 2017 - Progression - gonna switch it up
FEB 2018 - Kadcyla 3 cycles ---->progression :(
MAY30th - bronchoscopy, w/foundation1 - her2 enriched
Aug 27, 2018 - start clinical trial ZW25
JAN 2019 - ZW25 seems to be keeping me stable
APRIL 2019 - ONE DOZEN YEARS LIVING METASTATIC
MAY 2019 - progression back on herceptin add xeloda
JUNE 2019 - "6 mos average survival" LMD & CNS new single brain met - one zap during 5 days true beam SBRT to cord met
10/30/19 - stable brain and cord. progression lungs and bones. washing out. applying for ds8201a w nivolumab. hope they take me.
12/27/19 - begin ds8401a w nivolumab. after 2nd cycle nodes melt away. after 3rd cycle chest scan shows Improvement, brain MRI shows improvement, resolved areas & nothing new. switch to plain ENHERTU. after 4th cycle, PETscan shows mostly resolved or improved results. Markers near normal. I'm stunned but grateful.
10/26/20 - June 2021 Tucatinib/xeloda/herceptin - stable ish.
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Old 01-18-2009, 06:02 AM   #8
Sheila
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Turbo
I was on the Herceptin Xeloda combo for 1 1/2 years for mets to the supraclavicular nodes...I did the Herceptin every 3 weeks, and the Xeloda was 2 weeks on, 1 off, 2500 mg a day...3 in the morning and 2 at night...except for the skin issues (peeling cracking) on my hands and some burning in the feet towards the end, I thought it was a dream combo...no other side effects whatsoever....wish I could have stayed on it forecer. Good Luck...seems that 2500mg a daay is the new standard, some Dr's want to try to use 4000mg, and the studies show 2500 is just as effective.
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Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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Old 01-18-2009, 11:05 AM   #9
turbo
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thanks sheila same regimen i am on only 3500 xeloda a day ...seems high ,I weigh 137 , dose is supposed to correlate to. I Know my doc will reduce if I have side effects...I have been on 6 days and have some nausea....Where can I find info on the new standard dosage? Thanks Turbo
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