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Old 10-01-2007, 10:27 PM   #1
Esther
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Back on Herceptin + Tykerb

I had my first infusion of Herceptin today, since I stopped taking it in
April. I still don't know if the rise in liver functions and bilirubin was a blip
or reallity.

But after checking around a bit, it didn't seem that Herceptin and Tykerb
were contra-indicated, or there is no proof of this. So even though I am still scheduled for a pet/ct on Wed, I went ahead and started Herceptin again anyway.

Herceptin alone kept my liver and bone mets at bay for almost 2 1/2 years, I always felt nervous stopping it. I feel better now that I have my trusty little H in my veins!!!

Whatever else I find out about my liver, I think I will continue to stay on
Herceptin and Tykerb until I find a reason to not do so.

As far as the RFA goes, right now I don't know if there are any liver lesions that need treating, I won't find out until after the pet/ct on Wed. But it does appear that alot of facilities do not like to do RFA if there are other sites involved in mets. Wonder if you can just say you have mets to liver and skate by like that and not mention other sites if they are controlled, or NED.

I am still researching my options at LLUMC, UCLA and Cedars-Sinai. All three of those centers perform RFA for liver tumors. Stanford perfroms Cyber-knife for liver mets tumors as well. I'm getting my information ready, in case I do have the need to move quickly with one of these options.
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Old 10-01-2007, 10:37 PM   #2
hutchibk
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I would love to keep up with your research, Esther! In the event that I ever show mets to liver (my bilirubin was ever so slightly elevated 4 weeks ago, but not this week when we did labs)... I need to have my research in order for presentation to my onc. I think he gets a kick out of my presentations, and it really contributes to our game plan.

Best of luck this week.
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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 10-02-2007, 08:27 AM   #3
Carolyns
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Hi Esther,

That is good news that you got what you think you need by adding Herceptin back into the mix. I find that I need to drink extra water and sometimes go on the bland diet (is that what the call it?) from time to time. I am still hopeful that you have experienced a blip on the screen and that you will continue to be stable or improve with this combo.

Brenda - Just like you, I always prepare for my meetings with my doctor and try to come well prepared with questions and findings to discuss.

Love, Hope, Peace,
Carolyn
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Old 10-10-2007, 06:43 AM   #4
Lala
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Esther
Wishing you the best in your scans and hoping it shows a clean liver.
I hope you tolerate the Herceptin and Tykerb combo; it certainly is interesting combo. Once again you are paving the way. Stay strong.
Hugs,
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DX Fall05 Stage 4 er+ pr+ her2+ liver and bone mets
DX Fall06 Brain mets, Brain mets gone Spring 2007
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Old 10-10-2007, 08:00 PM   #5
Esther
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Tests results

Well I got back the results from the pet/ct scan and according to the results, my liver does not have progression. There is only one lesion that may be scar tissue and a long shot second small one barely visible.

This after the Feb 04 scans showed "innumerable mets lesions too many to count" on my liver!

I am scheduled to consult with the specialist at LLUMC next Tuesday the 16th of Oct at noon...maybe I should take him sandwich, I'm cutting into his lunch!

I will also check into topo therapy at City of Hope and cyberknife at Stanford. I'll keep the board posted on what I find out in case anyone else is thinking about this.

I may not need these options right now, but I want to be a patient at these centers and know my options, just in case I need them and need to move quickly.
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Old 10-10-2007, 08:16 PM   #6
Bev
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Congrats Esther. Sounds like good reults to me. Let us know how it goes. Bev
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Old 10-13-2007, 01:27 PM   #7
StephN
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Thumbs up good going!

Wow, Esther -
I am so glad that the PET did not show up anything to be worried about right now. I have had liver functions move a bit from time to time, but always an anomoly.

Almost missed this lastest in your ongoing cancer story. Need to check the other forums in this site from time to time! Seems there was some research a while back that showed Herceptin could work well with Tykerb. Hope your other mets are getting "hosed" by the new combo.
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"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 10-22-2007, 03:26 PM   #8
retrobetty
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Hi has anyone been taken off Herceptin for long periods of time? I have met on thorasic spine that has not increased in size for the past year and half, I have been off Herceptin for a year. Every doctor keeps calling a me a strange or difficult case. Anyone else been lucky enough to stay off for long periods I am having hard time hearing not to do anything but wait. Hanging out waitting for it to show somewhere else is not my idea of being proactive. Thanks
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Old 10-22-2007, 04:12 PM   #9
chrisy
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Esther, good news that there is so far nothing to RFA. Question, have you looked into whether insurance would cover this procedure? I saw a Blue Cross/Blue Shield policy statement which indicated that they would not pay for this procedure or surgery for breast cancer patients. Just asking.
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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 10-23-2007, 05:18 AM   #10
tousled1
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Esther,

That's great news! I'd take the sandwich and probably one for yourself as well. You can have a "working" lunch as I know you'll have many questions you want answers to.
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Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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Old 11-15-2007, 10:06 PM   #11
dajawood
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Liver Mets

Ester,

I received the same diagnosis almost verbatium this past April. Your message gives me hope that it may be possible for my liver mets to improve. Thanks for sharing.
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