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Old 08-19-2014, 05:41 PM   #1
Camiddendorf
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Cardiac toxicity with Herceptin

Hi all,
I would like to know if you have experience with decreased ejection fraction secondary to Herceptin and if you were able to resume Herceptin if the drug was temporarily discontinued. Unfortunately I was diagnosed with left-sided HER2+, invasive lobular breast cancer which is ER + and PR- In August 2013. I have received cardio toxic drugs including Adriamycin
. AC every 3weeks x4
. Taxol and Herceptin every week x12
. Radiation x34 doses
.Femara daily x5 years (recently initiated)

I started single dose Hercetin in April, and have received 6 doses. Plan was to have every 3 weeks for a year. now my EF =48%!! Was 80% prior to any treatment, then 70% at start of Taxol and Herceptin, then 62% in May and now in aug 2014, 48%!

I worried about Herceptin resistence but I really never considered cardio toxicity. Now I am feeling that the rug has literally been pulled from under my feet. Nothing I can do to improve my ejection fraction and I worry that the prognosis without Herceptin is markedly worse.
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Old 08-19-2014, 08:06 PM   #2
CoolBreeze
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Re: Cardiac toxicity with Herceptin

This has not happened to me, but I do know many, many cancer patients and it has happened to quite a few of them. Many have to go off Herceptin, which is scary, but they recover in a couple months and can go back on.

I'm sure there are some here who will chime in, but I wanted you to know you aren't alone. And, you can recover and continue treatment. *hugs*
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http://butdoctorihatepink.com

08/17/09 Dx'd.
Multifocal/multicentric IDC, largest 3.4 cm, associated ADH, LCIS, DCIS
HER2+ ER+/PR- Grade 3, Node Negative

10/20/2009: Right mastectomy, reconstruction with TE
12/02/2009: Six rounds TCH, switched to Taxol halfway through due to neuropathy
03/31/2010: Finished chemo
05/01/2010: Began tamoxifen, the worst drug ever
11/18/2010: Reconstruction completed
12/02/2010: Finished herceptin
05/21/2011: Liver Mets. Quit Tamoxifen
06/22/2011: Navelbine/Zometa/Herceptin
10/03/2011: Liver Resection, left lobe. Microwave ablation, right lobe - going for cure!
11/26/2011: C-Diff Superbug Infection, "worst case doctor had seen in 20 years"
03/28/2012: Progression in ablated section of the liver - no more cure. Started Abraxane, continue herceptin/zometa
10/10/2012: Progression continues, started Halaven, along with herceptin and zometa.
01/15/2013: Progression continues, started Gemzar and Perjeta, an unusual combo, continuing with herceptin and zometa
03/13/2013: Quit Gemzar, body just won't handle it. Staying on herceptin, zometa and perjeta.
04/03/2013: CT shows 50% regression in tumor, so am starting back on Gemzar with dose reduction, staying with perjeta/herceptin/zometa. Can't argue with success!
05/09/2013: Discussing SBRT with Radiology due to inability of bone marrow to recover from chemo.
06/07/2013: Fiducial placement for SBRT
07/03/2013: Chemo discontinued, on Perjeta, Herceptin and Zometa alone
07/25/2013: SBRT (gamma knife) begins
08/01/2013: SBRT completed
08/15/2013: STABLE! continuing with Perjeta, Herceptin, Zometa
06/18/2014: ***** NED!!!!***** continuing with Perjeta, Herceptin, Zometa
01/29/2014: Still NED. continuing with Perjeta, Herceptin. Zometa lowered to every 3 months instead of monthly.
11/08/2015: Progression throughout abdomen and lungs. Started TDM-1, aka Kadcyla. Other meds discontinued. Remission was nice while it lasted.

5/27/18: Stable. Kadcyla put me right back in the barn. I have two teeny spots on my lungs that are metabolically inactive, and liver is clean.

I’m beating this MFer. I was 51 when this started and had two kids, 22 and 12. Now I’m 60. My oldest got married and trying to start s family. My youngesg graduates from Caltech this June. My stepdaughter gave me grandkids. Life is fantastic.
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Old 08-20-2014, 08:38 PM   #3
pffida
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Re: Cardiac toxicity with Herceptin

I had problems with herceptin, developing cardio myopathy after about 3 or 4 treatments. The oncologist had had good success with waiting about six weeks, then restarting weekly treatments (at lower doses). It was hard going every week, but the heart problems went away and I've been fine ever since. See if your oncologist would be willing to try that.
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Diagnosed 11/06; IDC
Stage 1, Grade 2
MRM 12/06; 19 nodes removed, all negative
ER/PR-, HER2+++
  • 4 rounds AC - every 3 weeks
  • 3 rounds Taxol + Herceptin - every 3 weeks (developed allergy to Taxol so stopped treatment)
  • Weekly Herceptin after Herceptin-induced cardiomyopathy from treatments every 3 weeks
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Old 08-21-2014, 07:26 AM   #4
DianaMK
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Re: Cardiac toxicity with Herceptin

The first time I was on Herceptin I had a 10 point drop in my E.F. I took 6 weeks off and repeated echo, E.F. increased and I was able to resume.

I have now been on Herceptin for four years. Last year a 10 point drop again so I saw a cardiologist. I am on a beta blocker and my E.F. has maintained around 58%.
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12/2006 right lumpectomy - HER2-Stage 1
A/C x 4
Radiation
Herceptin - one year
6/2010 - Stage 4 - lung and skin mets
Lung resection
TCH x 6
12/2010 - right mastectomy
On Herceptin
Scans every six months
11/2013 - stable continue to watch spot on lung
Continue on Herceptin
6/2016 - 6 years Stage 4 - stable - continue Herceptin
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Old 08-21-2014, 02:29 PM   #5
Camiddendorf
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Red face Re: Cardiac toxicity with Herceptin

Thanks for the info. I am encouraged to know Herceptin could be renewed and will ask about weekly dose.My next ECHO in 3 weeks, so I will keep my fingers crossed. If I ever figure out how to attach my stats, I will do so :-)
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Old 09-03-2014, 05:54 AM   #6
vballmom
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Re: Cardiac toxicity with Herceptin

I was off Herceptin due to a lowered EF but was able to resume after a few months. I finished!
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Old 09-03-2014, 11:26 AM   #7
'lizbeth
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Re: Cardiac toxicity with Herceptin

I tried exercise and CoQ10 to help keep the ejection up. Discuss strategies with your doctors to minimize the effects of the cardiotoxicity.

Good wishes for your next scan to show an increase.
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