Heat Shock Therapy 90

Hi I am unregistered but it is Shonda Gaylord.. I am looking for any information you guys may have regarding heat shock therapy 90. I was presented with this trial today as an option and I am researching it. It was an unexpected change in treatment so I was completely unprepared for my visit today and caught off guard so what did I do? I cried for lack of anything else to do. I was confused and scared. I had just received my scan reports on Tuesday this week, and all bone mets appear to be "stable" with some possible healing, but there are lytic lesion which is activity. My tumor marker is not dropping. In fact it has slightly increased so she thinks I have gotten all the benefit from taxol I am going to get. So.... lets see, since January '09, I have recieved 5 months or a little less of navelbine - started Xeloda for 2 days - took a month holiday while I moved, - and then I will have done 5 months of taxol when we stop it. Does this sound right for an almost 4 yr survivor of metastic disease? She did tell me the longer I am on any chemo the shorter they time they will work before changing a while back. She is also wanting me to start a trial of 4 injections for anemia which has had some really good results in bone disease, but my HGB is 11.1 and it has to be under 11 to qualify. I have been as low as 8 in the past, but asymptamatic. I have been on taxol in the past for a year weekly and now 5 months weekly. I am almost addicted to it because I do so WELL on it w/ no to speak of side effects so I hate to leave it behind. ANyway if anyone could tell me anything anout HEAT SHOCK i would appreciate it.

Thanks so much
Shonda

[Rich66]

Hmmm. The injections for anemia sound strange to me. There's info out there to suggest anemia can be a beneficial "coping" mechanism in cancer patients. Maybe it's not what I think?

[Rich66]

Are you triple negative? Do you have a link to the trial?

I found this:
1: Expert Opin Investig Drugs. 2009 Sep;18(9):1375-83. Links
Retaspimycin hydrochloride (IPI-504): a novel heat shock protein inhibitor as an anticancer agent.

Hanson BE, Vesole DH.
Loyola University Chicago, Stritch School of Medicine, Division of Hematology/Oncology, Department of Medicine, 2160 S 1st Avenue Maywood, IL 60153, USA.
Heat shock proteins are vital to cell survival under conditions of stress. They bind client proteins to assist in protein stabilization, translocation of polypeptides across cell membranes and recovery of proteins from aggregates. Heat shock protein inhibitors are a diverse group of novel agents that have been demonstrated to have pro-apoptotic effects on malignant cells through inhibition of ATP binding on the ATP/ADP-binding pocket of the heat shock protein. Initial development of heat shock protein 90 inhibitors, geldanamycin and 17-AAG, were limited by hepatotoxicity and the need for solvent carrying agents. In contrast, retaspimycin, or IPI-504, a derivative of geldanamycin and 17-AAG, is highly soluble in water and generally well tolerated. In Phase I/II trials, retaspimycin has shown activity in NSCLC and gastrointestinal stromal tumor. The most promising activity was observed in gastrointestinal stromal tumors. Phase I/II trials are currently underway to evaluate the dosing schedules and activity of IPI-504 in breast cancer. Given the in vitro activity in diffuse large B-cell lymphoma, mantle cell lymphoma, melanoma, leukemia and pancreatic cancer, current and future trials are of clinical interest. This article reviews IPI-504 and its utility in a wide variety of cancer phenotypes.
PMID: 19642950 [PubMed - in process



Also..
If you or others are interested in a Taxane that can work against Taxol/Taxotere resistant cancer, there may be a trial for Tesetaxel:

http://www.medicalnewstoday.com/articles/135629.php

I am triple positive. The anemia injections are in a clinical triail. You only get 4. They have shown good results in bone mets. Thats the only mets I have but I have alot. All the info I am finding about HSP90 is what it is and not what they use to treat it. I am waiting to hear back from my nurse on info regarding treatment since it is so new she doesn't even know. She said she found out the day before I did about it and she works with the doc. The doc was extremely excited about it and when I cried they are so caring and tried to keep me up beat by getting me excited of all the new and other drugs out there. SO why do I feel my options are so limited in my mind? I have been on TAxol for almost 5 months. They wanted me to do taxol avastin originall, but due to HBP issues that are controlled we had to get to go ahead from my heart doc and kidnery doc. We got that, but no avastin.. I asked about adding avastin to taxol yesterday and she said well since we've gotten the goodie out of taxol we won't ad avastin to it but we can ad it to another chemo, but didn't say which one or I cando this Heat shock theraoy 90. So better today, but still confused and sad for the time being until I talk my way out of it!

[chrisy]

Hi Shonda,

Do not lose heart. As a 4 year survivor you've been through a lot...and probably need and deserve a break! There is a lot of research going on, and for me that's where the hope lies.

I'm not super familiar with the anti HSP90 agents - been following the discussion here with mild interest. I now have a stronger interest in learning more about this after hearing a discussion on this at ASCO Breast Cancer Symposium last week in SF. I'm attaching a general link about one trial

http://www.medicalnewstoday.com/articles/124277.php

In SF, they discussed basics of what HSP90 is - my take away was that it is a "chaperone" that helps its "clients" in their growth and signalling mechanisms. In cancer, these clients are associated with multiple features of cancer. Her2 is one of the most active clients, so Her2+ cancer is an excellent target. But because it also has other clients, inhibiting HSP90 could potentially interfere with other pathways for the cancer to grow. Shutting down multiple pathways is important. (Nirvana would be a complete blockade of all the pathways).

In early trials, response rates have been comparable with Neratinib and TDM1 - both of which have also generated a lot of excitement in the anti-cancer community. So there is good reason for your doctor to be excited about this.

Participating in trials is a mixed bag - you get the chance of getting a therapy that is not really available but may be better than what's out there. The downside is it is not proven as to efficacy or safety. So you do want to choose carefully.

If it were me, I'd ask my doctor for more information on this agent, and the trial. As a targeted agent it MAY be less toxic than a traditional chemo and give your body a chance to recover.

[StephN]

Hello -
There was a small trial here involving a heat shock drug. It is not exactly the same, and I think never went past this trial. I had a friend who was in this (actualy the last one not to get dropped for progression) and she got about 16 months with tumor reduction then stability, before progression.
They were doing phase II and settled on a dose that was pretty tolerable for her. She had some nausea day of dose, but felt pretty well after that. It was a weekly infusion. She eventually moved on to Tykerb, but not fast enough for it to be effective and passed away late summer.

The drug you are looking at has much more research and data behind it, so you would not be so much trailblazing as participating in the fine-tuning stage.

Hope you get the info you want.

[tricia keegan]

Shonda, I have no advice to offer but know you from komen way back and just want to send good wishes to you