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Old 06-15-2017, 02:05 PM   #1
Mtngrl
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Join Date: May 2011
Location: Denver, CO
Posts: 1,427
Back on Tykerb--Still Rough

I was on Tykerb and Herceptin in 2012. I remember having diarrhea, but I also remember it being manageable with Imodium, and I think I eventually got used to it.

About a year ago I was on Kadcyla and Tykerb. The diarrhea was relentless and constant. After a pretty short time, and trying a dose reduction, my doctor and I threw in the towel.

Now I'm back on it because a lung biopsy and a Foundation One report show some evidence that I might be developing Herceptin resistance, and the tumor board thinks Tykerb/Lapatinib can fix that. I'm also getting Navelbine.

And there's that extensive, stubborn (painful, worrisome, constant) diarrhea again! After 4 doses at 1250 mg per day, I stopped the Tykerb for 4 days. When I went back on, the same day I started the second round of Navelbine, I began taking 1000 mg per day instead of 1250, and took 4 mg of Imodium at the same time, then again 4 hours later.

It's not perfect, but it's better. I also have some Lomotil that was prescribed last year. I alternate one tablet of Lomotil with one tablet of Imodium whenever I have abdominal pain and/or rumbling. I think raw vegetables exacerbate it, so I'm avoiding those. I take a probiotic supplement, and I eat yogurt.

My doctor left the decision up to me. I was willing to try again because I did eventually get used to it 5 years ago, and it seems to be the right drug for me at this time.

I have lung mets. I periodically test my O2 saturation with a little device that reads that plus pulse. My O2 and pulse numbers have been good. I'm sleeping pretty well. In short, there's reason to think this drug combination is a good one for me.

I'm posting this in case it helps someone else who's trying to do Tykerb/Lapatinib. I will let you know what the next scan shows.
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Amy
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4/19/11 Diagnosed invasive ductal carcinoma in left breast; 2.3 cm tumor, 1 axillary lymph node, weakly ER+, HER2+++
4/29/11 CT scan shows suspicious lesions on liver and lungs
5/17/11 liver biopsy
5/24/11 liver met confirmed--Stage IV at diagnosis
5/27/11 Begin weekly Taxol & Herceptin for 3 months (standard of care at the time of my DX)
7/18/11 Switch to weekly Abraxane & Herceptin due to Taxol allergy
8/29/11 CT scan shows no new lesions & old lesions shrinking
9/27/11 Finish Abraxane. Start Herceptin every 3 weeks. Begin taking Arimidex
10/17/11--Brain MRI--No Brain mets
12/5/11 PET scan--Almost NED
5/15/12 PET scan shows progression-breast/chest/spine (one vertebra)
5/22/12 Stop taking Arimidex; stay on Herceptin
6/11/12 Started Tykerb and Herceptin on clinical trial (w/no chemo)
9/24/12 CT scan--No new mets. Everything stable.
3/11/13 CT Scan--two small new possible mets and odd looking area in left lung getting larger.
4/2/13--Biopsy of suspicious area in lower left lung. Mets to lung confirmed.
4/30/13 Begin Kadcyla/TDM-1
8/16/13 PET scan "mixed," with some areas of increased uptake, but also some definite improvement, so I'll stay on TDM-1/Kadcyla.
11/11/13 Finally get hormone receptor results from lung biopsy of 4/2/13. My cancer is no longer ER positive.
11/13/13 PET scan mixed results again. We're calling it "stable." Problems breathing on exertion.
2/18/14 PET scan shows a new lesion and newly active lymph node in chest, other progression. Bye bye TDM-1.
2/28/14 Begin Herceptin/Perjeta every 3 weeks.
6/8/14 PET "mixed," with no new lesions, and everything but lower lungs improving. My breathing is better.
8/18/14 PET "mixed" again. Upper lungs & one spine met stable, lower lungs less FDG avid, original tumor more avid, one lymph node in mediastinum more avid.
9/1/14 Begin taking Xeloda one week on, one week off. Will also stay on Herceptin and Perjeta every three weeks.
12/11/14 PET Scan--no new lesions, and everything looks better than it did.
3/20/15 PET Scan--no new lesions, but lower lung lesions larger and a bit more avid.
4/13/15 Increasing Xeloda dose to 10 days on, one week off.
7/1/15 Scan "mixed" again, but suggests continuing progression. Stop Xeloda. Substitute Abraxane every 3 weeks starting 7/13.
10/28/15 PET scan shows dramatic improvement everywhere. All lesions except lower lungs have resolved; lower lungs noticeably improved.
12/18/15 Last Abraxane. Continue on Herceptin and Perjeta alone beginning 1/8/16.
1/27/16 PET scan shows cancer is stable.
5/11/16 PET scan shows uptake in some areas that were resolved on the last two scans.
6/3/16 Begin Kadcyla and Tykerb combination
6/5 - 6/23 Horrible diarrhea from K&T together. Got pneumonia.
7/15/16 Begin Kadcyla only every 3 weeks.
9/6/16 Begin radiation therapy on right lung lesion that caused the pneumonia.
10/3/16 Last of 12 radiation treatments to right lung.
11/4/16 Huffing and puffing, low O2, high heart rate, on tiniest bit of exertion. Diagnosed as radiation pneumonitis. Treated with Prednisone.
11/11/16 PET scan shows significant improvement to radiated part of right lung BUT a bunch of new lung lesions, and the bone met is getting worse.
11/22/16 Begin Eribulin and Herceptin. H every 3 weeks. E two weeks on, one week off.
3/6/17 Scan shows progression in lungs. Bone met a little better.
3/23/17 Lung biopsy. Tumor sampled is ER-, PR+ (5%), HER2+++. Getting Herceptin and Perjeta as a maintenance treatment.
5/31/17 Port placement
6/1/17 Start Navelbine & Tykerb
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