Weekly Herceptin versus Triple dosage??

[syncmaster174v]

Is anyone able to shed some light on the following? I can't find it in the medical literature.

I am told by my oncologist that the FDA approved Herceptin given weekly - but she also admininsters it every two weeks at double the dose as well as triple the dose every three weeks.

Does anyone have any literature/research I could read about the triple dose of Herceptin administered every three weeks?
I'm concerned about it's safety as well as how effect can it be given every three weeks? - do the antibodies stay effective for that length of time?

On the positive side, I will be returning to teaching in the fall and it would be very difficult to go weekly. I am planning to try triple the dose every three weeks - but I would like to find out where it is done plus any studies on this frequency of dosage.

Thanks for whatever leads you can give.

[Sheila]

I dont have any literater but if you go on the Genentech website, you can read info there. I have been on the every 3 week dose for 2 1/2 years with no problems....I would hate to go in every week just from a convenience standpoint.

[Becky]

The triple dose is just as effective as the weekly dose. Herceptin's half life is 20.8 days so the triple dose stays around just long enough. It also does not cause any worse potential for cardiac problems as the weekly dose either.


I started out with weeklies but switched over to the every 3 weeks regime. It was really nice to make that switch because I felt I was living at the cancer center.

Best wishes to you in your treatment.

Becky

[Jean]

Hi Becky,
Just read your post on the weekly herceptin - verses the 3 wk dose.
I just started trt this past Thur. Herceptin/chemo - I will have 9 wkly
doses of herceptin then there after every 3 wks. Is this considered standard for herceptin trt? I thought it was? Thank you for any additional info.

Regards,
Jean

[Becky]

I believe it is common to start with the weekly dosage because it is combined with chemotherapy. I started receiving Herceptin after chemo was over (benefited from last year's ASCO meeting where I was 3 months post chemo at that point).


Because of that, I could receive it either way but my onc (at the time) was more comfortable with weeklies so I had 12 or 13 weeklies before I switched to the every 3 week for convenience (changed oncs at my 7th weekly treatment).

I know if you do the traditional 4 AC followed by taxol you get the taxol/herceptin in 12 weekly doses and after that, most oncs switch you to the every 3 week regime.

I also believe they like to start with weeklies because it is a lower dose just in case you have a bad reaction (???).

I hope you are doing well Jean. I really think a lot of you and what you are doing for yourself.

Becky

[Chelee]

I don't know which way is better? All I can tell you is the oncologist at my center all seem to agree that weekly is better with herceptin. Yet they tell me if I perfer to come in every three weeks...that will be fine too. In fact I started out on weekly herceptin...then out of the blue my oncologist changed me one month to a triple dose thinking I would like that better...meaning less trips.

Which I admit...I DID like it better...and I actually felt better with the triple dose...don't know why...but I did. So I don't think it makes much difference. Good luck...

Chelee

[Roz]

I think that the half life of Herceptin is in fact 28 days. That means that after 28 days you have half the effectiveness . Google herceptin and half life to double check

[syncmaster174v]

Thank you to all! I appreciate your help and will do some research on the topic.

Because of your answers, I do feel better about it.

I am concerned about swelling in my legs and I'm on weekly herceptin - my oncologist says it's nothing to worry about- but I never had swollen legs before.

[Lolly]

Regarding the swollen legs while on Herceptin; I assume your onc is following your heart function with either MUGA's or Echo's. If your heart function is being compromised by Herceptin, one of the symptoms can be puffy ankles and shortness of breath.

[Jean]

Just had my first trt of herceptin and chemo on Thurs. Was told to drink lots of water and flush my body. Drank huge amounts of water. Have been taking my temp and checking my weight on a scale. The next day my weight was up by 9 pds. My legs were a bit swollen - breathing was fine. Today my weight is back to normal. My question is the following: in the early trt phase such as I am at - when does the dr. check the heart? When you expierence swollen legs etc? This Thurs. I will have my second herceptin trt. I am hoping that I will not go through that water retention again as it wore me out the last 48 hrs. I kept drinking to flush - but I felt as if my body could not keep up. I am feeling fine and my legs seem normal - I do feel a little puffy in my face but nothing of great significance. I guess my question is when you first begin with the herceptin trt what is the usual procedure for the onc? At the cancer center they told me if I had shortness of breath with swollen legs to call the dr. Since my breathing was normal I was not concerned.
Any advise?
Thanks,
Jean

[nancylove]

Hi there, Im just at the end of my herceptin one year treatment and have beeen on 3 week doses for 3months now that I ended my Navelbine treatments which were weekly x18. I was amazed that Herceptin half life is 20 days WOW
I am having side effects now that i am on the 3 week dose,
I find a signif weight gain the first week, and also some hand and foot burning which reminds me of taxol but not nearly so bad, does anyone have this??? it is worse in the am than the rest of the day.
Overall though i feel great!
I do want this port out though as it hurts so much when they access it no matter if i use numbing creme or not. They have to use a one inch needle and ow ow ow.
So i hope to have it out as soon as my scans are done and I come out ok!! i hope and pray! Nancy Love

[Bev]

Hi Jean,

My doc did a baseline muga before any chemo and once every 3 mos after. Heart failure is rare, but if you have any symptoms such as swelling, I think you should leave a message on the onc's nurse message triage line tomorrow. "Hey this is what happening and what should I do" You'll probably be fine, but asking doesn't hurt. You'll feel better if you take charge and are reassured your LVF is fine anyways. I think MUGAS or Echos are standard. Good Luck, BB

[Bev]

PS. I had no swelling or weight gain from herceptin. Most of my evil side effects occurred from taxol or the premeds. Run a search on this site for more on side effects. BB

[syncmaster174v]

My oncologist is not concerned about the swollen legs - my mugascan was fine in April and I'm due for one at the end of June. I don't have shortness of breath - but I certainly don't appreciate the swollen feeling in my legs.

[MJo]

RE: Swollen legsI think any swelling should be reported to the doctor. Regarding "huge amounts of water," I remember my oncologist telling me he wanted me to drink lots of water but don't "drown myself." I planned to take herceptin every three weeks because my muga score dropped 11 points and I thought it would be easier on the heart. The oncologist told me it wouldn't make a difference and I listened to him this time. I had no trouble with my triple dose except for tiredness the first two days, tingling in hands and feet. I actually measured my ankle circumference with a tape measure and I'm going to check it every week for swelling. MJo

[Val Pfeiffer]

I will finish one year on triple dose of maintenance Herceptin in September. How many of you who are/were on maintenance Herceptin longer than one year were Stage IV? How many were Stage III? I was IIIB (9 cm tumor, 5/8+ nodes). My onc and I talked about going to a triple dose every three months after the first year. I'm interested in knowing what people are getting if they were Stage III or Stage IV?

FYI--I have not had any side effects that are worth mentioning from the triple dose.

Thanks :-)
Val

[Sherryg683]

I am taking Herceptin weekly, I finished my treatment over a month ago. I asked my Oncologist about going on it every 3 weeks and he told me that he has been a little disappointed personally in what he has seen on patients that were doing it every 3 weeks. I did not question him as to what he meant by disappointed. He said he preferred to keep me on it every week till I was at least a year out from remission. My good friend also uses my Oncologist and he had her on Herceptin every 3 weeks but she was a stage II opposed to myself who's a Stage IV. Maybe it's different with stages and chances of reoccurance being greater...sherryg683

[Sheila]

I AM Stage IV AND I get it every 3 weeks, always have...that is how the Onc's in Chicago who pioneered the clinical trials of Herceptin recommend it for all patients who receive it, unless there is a toleration problem

[harrie]

During my chemo, I am given herceptin weekly. My initial dose was a loading dose and that was double. So every wk now I am getting about 100mg. After my 6 rounds of chemo, I will be getting herceptin every 3 wks at triple the dosage )300mg to make one yr.

[tousled1]

Here's a link of an article from ASCO which shows no difference in weekly vs 3 week Herceptin.

www.bcaction.org/Pages/SearchablePages/<WBR>2002Newsletters/Newsletter070H.html

Article also states that Herceptin stays in body 3-4 weeks.

Hope this helps.