Tykerb and Tired

[Ceesun]

Has anyone on the full dose experienced a lot of fatigue requiring 1-2 naps a day. Pooped! Ceesun

[Believe51]

Hey Ceesun, I am sorry to hear of your fatique and want to tell you Ed had a tiring time on the Tykerb. If you ask him about fatique he will tell you that the Ixempra has been the worst of all 4 treatments. Take those naps Sweetie and try to do this guilt-free. Follow those urges closely and know when to push yourself if needed. Right now rest is important, let the drugs work their magic! Sending you love today and always. Keep the faith and stay strong.>>Believe51

[ElaineM]

I agree with Believe. We as women sometimes feel guilty when we need more rest. We are so used to doing it all. Now is the time to kick back and relax a little.

[SoCalGal]

I'm not really tired - I'm more like - EXHAUSTED!!

Took an 8 day tykerb break and felt considerably better.

Have been gradually weaning back up to full dose. Up to (4) a day for the past few days. I am so friggin' pooped. I don't exactly know what to "do" but I am noticing that when I force (and I mean force) myself to walk more I feel better. I know that exercise it the only cure for chemo fatigue. Blah, blah, blah.

I don't know if anyone's really studied the long term effects of tykerb. For me it's been 2 years. I can tell you it makes you really tired!

[jml]

Just took my very 1st dose of Tykerb tonight.
I almost started crying...don't know why. Weird. My dog was staring at me like I'm crazy.
I'm hoping for the very best, first & foremost, the return of NED, but also, hoping & praying the SE's are manageable.
Thanks to everyone here who's posted about their experiences on Tykerb - it makes the path for those of us who follow in your footsteps a little less bumpy.

[Believe51]

Jml, doggie's reaction made me smile, please kiss him for me tonight. Best of luck on your quest for NED.....hopefully we can all meet up together.>>Believe51

[michka]

Hi Ceesun
I took Tykerb for one year. (5 pills in the morning). I was so tired that my onc had me take it 3 weeks and stop one week during the last 4 months. One month after the end of the treatment, my energy came back.
I send you hugs and strength.
Michka

[Lani]

I repeat it here:


A phase I dose-escalation study of 5-day intermittent oral lapatinib therapy with biomarker analysis in patients with HER-2-overexpressing breast cancer.

Sub-category: Tyrosine Kinase Inhibitors

Category: Developmental Therapeutics: Molecular Therapeutics

Meeting: 2009 ASCO Annual Meeting


Citation: J Clin Oncol 27, 2009 (suppl; abstr e14530)

Abstract No: e14530





Author(s): A. J. Chien, G. Auerback, H. S. Rugo, M. Melisko, P. N. Munster, E. Khanafshar, K. G. Ordovas, E. F. Petricoin, K. M. Koch, M. M. Moasser; University of California, San Francisco, San Francisco, CA; George Mason University, Manassas, VA; GlaxoSmithKline, Research Triangle Park, NC


Abstract:

Background: Although current HER2 targeting agents have made measurable impact on the treatment of HER2overexpressing breast cancer, their effects have been modest. Recent evidence has redefined the target of interest as the HER2-HER3 signaling dimer and identified inherent signal buffering capacity that protects it against partial inhibitors of HER2 function. In preclinical studies, HER2 catalytic function and HER2-HER3 signaling can be suppressed, but this requires higher fully inactivating doses of HER- family tyrosine kinase inhibitors (TKIs) leading to apoptotic tumor cell death. We hypothesize that TKIs may be much more clinically effective if used at much higher and fully inactivating doses. Such high dosing may only be tolerable if given intermittently rather than continuously. Methods: To test this hypothesis clinically, we conducted a phase 1 dose-escalation study of a 5-day course of lapatinib (Lp) in women with advanced HER2-overexpressing breast cancer. Lp was administered on days 1-5 of a 14 day cycle. Starting Lp dose was 1750 mg/day and was escalated in cohorts of 3 until the maximum tolerated dose (MTD) was defined. The first cycle of Lp therapy was bracketed by tumor fine needle aspirations and serologic studies, performed at baseline and on day 5. Functional signaling pathway biomarker analysis was performed on tumor lysates using Reverse Phase Protein Microarrays to assay the inactivation of HER2-HER3 signaling. Plasma Lp concentration was assayed at all dose levels and cardiac function was rigorously monitored. Tumor core biopsies were performed on a subset of patients at the MTD to determine tissue Lp levels. Results: 17 patients have been treated to date. No grade 4 or serious adverse events (AEs) attributable to Lp have been noted. 1 patient experienced dose-limiting toxicity at dose level 6 (7000 mg/day) consisting of grade 3 diarrhea despite maximal anti-diarrheal support. There have been no cardiac AEs. The most common AEs include grade 2 diarrhea, nausea, vomiting, acne. Conclusions: The MTD and systemic exposure of Lp can be considerably increased throsugh intermittent dosing.