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Old 11-20-2007, 08:02 PM   #1
StephN
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Thumbs up HER2 bc mets? New drug show MUCH promise

Tanespimycin (was known as KOS-953) is taken with Herceptin. One drawback is that you can't have had a regimen that included Herceptin. This drug is used for multiple myloma and other conditions, and may be avail off label.

Tanespimycin is an Hsp90 inhibitor that has demonstrated the potential to disrupt the activity of multiple oncogenes and cell signaling pathways implicated in tumor growth, including HER2, a key pathway in breast cancer.

I am posting this as it seems to have gone under the radar of the clinical trial sleuths we have here.

Definition from the National Cancer Institute:
tanespimycin
A benzoquinone antineoplastic antibiotic derived from the antineoplastic antibiotic geldanamycin. Tanespimycin binds to and inhibits the cytosolic chaperone functions of heat shock protein 90 (HSP90). HSP90 maintains the stability and functional shape of many oncogenic signaling proteins; the inhibition of HSP90 promotes the proteasomal degradation of oncogenic signaling proteins that may be overexpressed by tumor cells. Check for active clinical trials or closed clinical trials using this agent. (NCI Thesaurus)


Kosan's Hsp90 Inhibitor, Tanespimycin, Shows Promising Antitumor Activity In Phase 2 Trial Of Patients With HER2-Positive Metastatic Breast Cancer

Link to the info from San Antonio last year - I am sure there will be an update this year:

http://www.medicalnewstoday.com/articles/59083.php

I have a friend here who is on this trial - she was number 7 enrolled. She says there are now some 40 women enrolled and the trial has more sites. She has tumors in unusual places (on aorta for one) and during her neoadjuvent treatment her primary tumor grew from 1.5 to 8 cm and metastesized. Her disease is VERY agressive and hard to halt. In a little over a year her tumors have shrunk and nothing new. She keeps her hair and can still work.

Just wanted to mention this as some here are seeking new treatment for advancing disease and here is something with a new twist, working against the heat shock protein as well as HER2 pathways.
__________________
"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 11-20-2007, 10:03 PM   #2
Jean
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Steph,
I was thrilled to read about your friend and her great results on Tanespimycin. As I understand from your post this drug is combined with herceptin, but cannot be used if a person had prior treatment with hercpetin. Can you explain why? Are there any trials with this drug and early stage cancers, or has it only be used for spread of disease?

Wishing you and your family the very best and blessing on Thanksgiving.
We have so much to be Thankful for.

Kind Regards,
jean
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Stage 1, Grade 1, 3/30/05
Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
Herceptin 5/06 - for 1 yr.
9/06 Completed chemo
Started Femara Sept. 2006
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Old 11-21-2007, 06:19 AM   #3
eric
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Steph,

This appears to be a great highlight. I've been consulting with a doc at sloan as a 2nd opinion and he strongly belives in a heat shock trial as a next step for Caryn.

Thanks,
Eric
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Old 11-21-2007, 07:54 AM   #4
Hopeful
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Question Clarification?

The entry criteria says "No concurrent Herceptin," but not "no prior Herceptin." I assume this rules out only patients who received Herceptin with another drug, and not Herceptin monotherapy (i.e., "late" Herceptin)?

Hopeful
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Old 11-22-2007, 05:01 PM   #5
fullofbeans
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Thanks Steph for this interesting post.
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35 y/o
June 06: BC stage I
Grade 3; ER/PR neg
Her-2+++; lumpectomies

Aug 06: Stage IV
liver mets: 6 tumours
July 06 to Jan 07: 2*FEC+6*Taxotere; 3*TACE; LITT
March 07- Sept 07: Vaccination trial (phase 2, peptide based) at the UW (Seattle).
Herceptin since 2006
NED til Oct 09
Recurrence Oct 2009: to internal mammary gland since October 2009 missed on Oct and March 2010 scan.. palpable nodes in May 2010 when I realised..
Nov 2011:7 mets to lungs progressing fast failed hercp/tykerb/xeloda combo..

superior vena cava blocked: stent but face remains puffy

April 2012: Teresa Trial, randomised to TDM1
Nov 2012 progressing on TDM1
Dec 2012 blockage of my airways by tumours, obliteration of these blocking tumours breathing better but hoping for more- at mo too many tumours to count in the lungs and nodes.

Dec 2012 Starting new trial S-222611 phase 1b dual egfr her2+ inhibitor.



'Under no circumstances should you lose hope..' Dalai Lama
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Old 11-22-2007, 10:39 PM   #6
Soccermom
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Thanks from me too, Steph! I was just wondering if this one is listed in the "trials forum here"...hmmm.
Knowing that the "arsenal" of Her2 weapons continues to grow, gives me comfort.

Marcia
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Old 11-23-2007, 12:21 PM   #7
StephN
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No, Marcia -
I had not put this in the Clinical Trials section as I noticed that the link was to a bunch of different trials that a person would have to sift through to find the breast cancer one. Have not had the time to isolate a link to add in the other forum.

Hopeful & Jean - I can't clarify as I am not the one in the trial who has the documentation. If you find the trial, then there is always a number to call or an email address for questions. This appears to be another instance where Herceptin is synergistic with another drug.

When I did a search on this site for this drug either with its actual name or the letter/number name, I did not get anything. But thought I posted with the letter/number name a while back. Maybe when the hacker "ate" a week's worth of posts!
__________________
"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 11-23-2007, 04:58 PM   #8
Soccermom
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Hi StephN,
I tried to find it to post the link and like you say there were so many to sift through...again, thank you for posting Steph!
Hugs,marcia
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