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Old 09-09-2008, 08:56 PM   #1
Rich66
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Does T-M1 trial require prior chemo?

My mom only had radiation and arimidex after surgery. Trying to understand if she has to work through other treatments before being eligible for trials.
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Old 09-09-2008, 09:00 PM   #2
lilyecuadorian
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Rich I think you need to be resistent to herceptin ,
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Lily
Diag April/06 5 months after give birth my son Max
stage IV mets on liver (5 tumors) 38 year old,
her2+++ and ER+PR+ from32 nodes 4 positives
mastectomy right breast chemo before surgery herceptin/carboplatin/taxotere ,clear and surgery have radiation 20, `& then herceptin and tamoxifen
NED until Aug/07 body only then 'n June 04-06-07 .1 lesion of 1.6 cm on cerebellum ...novalis ,open sugery
5m.m brain met again novalis, 4mm.In the liver. Waiting 2 months now 3 tumors enroll on T-MCC trial start first infusion Nov 5/07 at Dec 17 scan show one tumor despair the 2nd and 3th diminish Doc said great results until March/08 ct scan show progression
03-05-08 start tykerb & xeloda
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Old 09-09-2008, 09:05 PM   #3
chrisy
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Rich, the trial I'm in requires prior chemo and herceptin. Most early drug trials do require some prior therapy - which actually makes sense, as you should go with the "proven" approach first.
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Chris in Scotts Valley
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 09-10-2008, 12:13 AM   #4
Rich66
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What woudl be considered standard or proven for a chemo naive mets patient?
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Old 09-10-2008, 08:52 AM   #5
runtolive
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http://www.clinicaltrials.gov/ct2/sh...erm=dm1&rank=5

i dont think your mom would qualify for any of the tras-dm1 trials. it is for metastatic patients. or patients who have recurrent tumors beyond the breast.

run
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Old 09-10-2008, 09:05 AM   #6
Rich66
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Mom has mets to the liver
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Old 09-10-2008, 09:32 AM   #7
chrisy
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Rich,
Your mom would probably qualify for the trial that runtolive posted in terms of the stage of disease and that she has not had prior chemo for metastatic disease. There is an exclusion for some types of chronic conditions including pulmonary, which might be an issue due to your mom's emphysema. You'd have to check on this.

Your other question, what would be 'standard or proven' - your mom's case is similar to mine, I had no adjuvant chemo so my first chemo experience was in the metastatic setting. Taxol+herceptin would be a 'proven' therapy (in fact, it is the other arm of the DM1 study that runtolive posted). I had this plus carboplatin, but I had extensive liver mets and they wanted to hit it hard.

Truth is, tho, even if your mom qualified for the trial, she might be in the taxol/herceptin arm anyway.

The taxanes (taxol and taxotere) are highly synergistic with herceptin, so that would be a good bet. I don't know how extensive her liver mets are, but if there is a significant amount of disease there, you want to get it under control.

Your mom and her doctor will have a better idea of how well she is able to tolerate treatment given her age and other health issues, but I can tell you that many women of her age do very well with chemo.

Rich, I'm so very impressed with the amount of research you've done on this - your mom is a very lucky woman to have you advocating on her behalf.
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Chris in Scotts Valley
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 09-10-2008, 09:43 AM   #8
chrisy
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Rich,

I also wanted to say, since your mom is "chemo naive", any type of chemo may deliver a really good wallop. She may be able to gain control over the liver mets quickly and then maintain on herceptin for a long time. There is good reason for hope.
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Chris in Scotts Valley
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 09-10-2008, 10:07 AM   #9
Rich66
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I just got off the phone with genentech. I didn't realize there are different versions of the trial with different exclusion criteria. Unfortunately I could not get any indication when the not recruiting trials would begin. She said "probably soon". Um hmm.

http://www.clinicaltrials.gov/ct2/re...mab-MCC-DM1%22

1
Not yet recruiting
A Study of of Trastuzumab-Mcc-DM1 Administered Intravenously to Patients With HER2-Positive Metastatic Breast Cancer Condition:
Metastatic Breast Cancer Intervention:
Drug: trastuzumab-MCC-DM1
2
Recruiting
A Study of Trastuzumab-MCC-DM1 Administered Intravenously to Patients With HER2-Positive Metastatic Breast Cancer Condition:
Metastatic Breast Cancer Intervention:
Drug: trastuzumab-MCC-DM1
3
Not yet recruiting
A Study of the Efficacy and Safety of Trastuzumab-Mcc-DM1 vs. Trastuzumab (Herceptin®) and Docetaxel (Taxotere®) in Patients With Metastatic HER2-Positive Breast Cancer Who Have Not Received Prior Chemotherapy for Metastatic Disease Condition:
Metastatic Breast Cancer Interventions:
Drug: trastuzumab-MCC-DM1; Drug: trastuzumab; Drug: docetaxel
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Old 09-10-2008, 10:39 AM   #10
runtolive
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rich .. where does your mom live.. city and state.
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Old 09-10-2008, 10:43 AM   #11
Rich66
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Lake Mills, WI
30 minutes from Madison, WI about an hour from Milwaukee, WI, about 2.5 hrs from Chicago
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Old 09-10-2008, 11:58 AM   #12
runtolive
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you are in that devils triangle.. no one center in your immediate area...

the closest sites listed on

http://www.clinicaltrials.gov/ct2/sh...ow_locs=Y#locn

are chicago and minneapolis

i would call genentech again and ask them if there will be any sites in the wisconsin area.
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Old 09-10-2008, 03:59 PM   #13
chrisy
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Definitely call on the locations. The list on the trial link is not accurate. I've been on that trial in California since February...and it does not show ANY locations in California. However, this trial DOES require 1 prior chemotherapy and Her2 directed therapy so I don't think mom would qualify.
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Chris in Scotts Valley
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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