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Old 09-20-2010, 10:35 AM   #1
Nguyen
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Join Date: Nov 2005
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Herceptin+Tykerp, Herceptin+Tykerb+Xeloda, Her+tykerb+Xeloda+Femara

Hello,

Does anyone have data comparing these combinations?

Herceptin_DM1,
Herceptin+Tykerp,
Herceptin+Tykerb+Xeloda,
Herceptin+Tykerb+Xeloda+Aromatase Inhibitor

If no comparing data, just effectiveness for each combi would also be great.

Many thanks,

Nguyen
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Old 09-20-2010, 01:27 PM   #2
Rich66
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Location: South East Wisconsin
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Re: Herceptin+Tykerp, Herceptin+Tykerb+Xeloda, Her+tykerb+Xeloda+Femara

I suspect there might be available data for the first two...maybe only the first. Flying relatively blind, as most chemo selection is, the last probably has the best chance of shutting down whatever pathway is fueling the cancer at that point. I imagine insurance providers might not like it much
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Old 09-20-2010, 01:58 PM   #3
hutchibk
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Re: Herceptin+Tykerp, Herceptin+Tykerb+Xeloda, Her+tykerb+Xeloda+Femara

Herc/Tykerb are still in trials (ALLTO Trial), so public data will be hard to come by just yet... as well as Herc/Tykerb/Xeloda, which I am not sure is being researched as a combo yet...

I have been on Herc/Tykerb for 2 years - added Tamoxifen in April, and have enjoyed pretty nice results and maintenance. We saw a new small adrenal spot in April so added Tamoxifen and it has helped hold it stable.

If we see any new progression on this weeks scans, we will consider TDM1 EAP.
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Brenda

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 09-21-2010, 05:15 AM   #4
Lori R
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Re: Herceptin+Tykerp, Herceptin+Tykerb+Xeloda, Her+tykerb+Xeloda+Femara

Nguyen,
I did find one trial that you might find of interest.

Below is the link. (sorry...I couldn't figure out how to make it active)
http://professional.cancerconsultant....aspx?id=42119

Trial:
The combination of Tykerb® (lapatinib) and Herceptin® (trastuzumab) improves progression-free survival with a trend toward improved survival compared with Tykerb monotherapy among HER2-positive breast cancer patients who have progressed on prior Herceptin-containing regimens.

The current clinical trial (EGF104900 trial) was an open-label, Phase III clinical trial that randomized 296 patients to Tykerb plus Herceptin or Tykerb alone in the treatment of HER2-positive, recurrent breast cancer.

The results showed progression in 8 weeks on Tykerb alone. Progression in 12.1 weeks for Tykerb + Herceptin.
__________________
2007
Oct - Diagnosed - Stage IV
5 c.m. IDC - Left Side er/pr- Her2+++
Node + 2/14 - Single Liver Met
Double Mastectomy
Nov - Begin T+H
2008
Feb-Complete 6 cycles- T&H- NED
March - Continue - Herceptin Only
April - Rads for 6 weeks
2009
Continue Herceptin - Continue NED
April - Recurrance- 3 cm. Liver Met
May - Cryosurgery
June - November - Abraxane + Herceptin
Aug - PET/CT - CTC = 0 Back to NED
2010
January - Continue NED
July - Recurrance - 3 cm Liver Met CTC=1
August - Cryosurgery #2
August - November Navelbine
November - Back to NED - End Navelbine
2011
Feb - Recur - 4 cm Liver Met - Same Left Lobe
March Surgery it is -Couldn't get a clean margin
July - Confirmed continued liver involvement
August - Begin Herceptin + Tykerb
October - Mixed results from H+T
Add Abraxane + H + T - Nov - April
2012
January PET Scan - It's working!!
April - Back to NED
July - Recurrance
August - Begin TDM-1 Trial (Taxol + TDM-1)
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