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Old 11-26-2007, 01:11 PM   #1
LauraP
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Question Tykerb Rash...help?

Hi. My name is Laura and I am a Stage IV survivor recently put on Tykerb in August of this year. I am taking it with Xeloda. I have handled the majority of side effects okay, but I have this rash. I have tried different cleansers as my skin is really sensitive. I didn't want to resort to taking topical meds to counteract the rash as those can sometimes be pretty harsh.

Do you all have any suggestions? I have read that lots of you have had the rash and that is common. Just not sure if I should take a more natural approach with cleansers or if I should try to get a prescription to conquer this thing.

My only concern is that I don't want to do less of the dosage. I want to stay at the dose I am at.

Any help you can provide me would be great!

Thanks!

Laura
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Diagnosed January 2005 at 32
Dx: Stage IV IDC with DCIS surrounding tumor, ER-, PR- HER2+, 1.6 cm primary tumor, grade III, 1/5 + nodes (.3mm focal point), 1 tumor on liver (1cm)
Surgery: Bilateral mastectomy with TRAM flap reconstruction
Treatment: 4 rounds dense dose EC, 12 rounds Taxol + Herceptin, indefinitely

Restaging in August 2005 at 33
Dx: Stage IV, 1 liver met (1cm),
Surgery: Liver resection as tumor was small enough to remove, interoperational sonogram identified no other liver lesions.
Treatment: 6 rounds of taxotere, carboplatin completed in January 2006.

Restaging in July 2007:
Dx: 2 lung lesions approx 1cm each
Surgery/treatment: in discussion with tumor board an oncology team.
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Old 11-26-2007, 09:53 PM   #2
hutchibk
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Hi Laura -

Here's the current info from The Oncologist (Peer review Journal for practicing Oncologists/Hemotologists)... regarding Tykerb/Xeloda rash:

*Employ a proactive approach in managing skin reactions.
*Suggest that patients use a thick, alcohol-free emollient cream.
*Suggest that patients use a sunscreen of SPF 25 or higher, preferably
containing zinc oxide or titanium dioxide
* If patient presents with rash, verify appropriate administration of drug and proceed with the following therapy algorithm:

Mild:
Minimally located
No impact on activities of daily life (ADL)
No sign of superinfection

(shows picture of mild rash occurrence across bridge of nose and cheeks)

Continue EGFR targeted treatment @current dose and monitor for change in severity.

topical hydrocortisone 1% or 2.5% cream and/or Clindamycin 1% gel

Reassess after 2 weeks, if reaction worsens or does not improve, proceed to next step.


Moderate:
Generalized
Mild Symptoms (e.g. pruritus, tenderness)
Minimal impact on ADL
No sign of superinfection

(shows picture of red worsened rash occurrence (pruritus) across nose, around nostrils, top lip, lower cheeks, and entire chin.)

Continue EGFR targeted treatment @current dose and monitor for change in severity. Continue treatment of the skin reaction with the following:

Hydrocortisone 2.5% cream or Clindamycin 1$ gel
or Pimecrolimus 1% cream
Plus Doxycycline 100mg BID or Monocycline 100mg BID

Reassess after 2 weeks, if reaction worsens or does not improve, proceed to next step.


Severe:
Generalized
Severe symptoms (e.g. pruritus, tenderness)
Significant impact on ADL
Potential sign of superinfection

(shows picture of worsened rash occurrence similar to moderate with more facial coverage and continuation to shoulders and neck)

Reduce EGFR targeted therapy as per label and monitor for change in severity. Continue treatment of skin reaction with the following:

Hydrocortisone 2.5% cream or Clindamycin 1$ gel
or Pimecrolimus 1% cream
Plus Doxycycline 100mg BID or Monocycline 100mg BID
Plus Medrol dose pack

Reassess after 2 weeks, if reaction worsens, dose interruption or discontinuation may be necessary.


Show it to your onc. I hope there is something here that can help you! Let us know how you are doing. There are more ladies here who might have additional ideas for you.
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NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."
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Old 11-27-2007, 08:08 PM   #3
LauraP
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Thanks!

Thanks so much for your help! i appreciate it and will give this a try.

Laura
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Diagnosed January 2005 at 32
Dx: Stage IV IDC with DCIS surrounding tumor, ER-, PR- HER2+, 1.6 cm primary tumor, grade III, 1/5 + nodes (.3mm focal point), 1 tumor on liver (1cm)
Surgery: Bilateral mastectomy with TRAM flap reconstruction
Treatment: 4 rounds dense dose EC, 12 rounds Taxol + Herceptin, indefinitely

Restaging in August 2005 at 33
Dx: Stage IV, 1 liver met (1cm),
Surgery: Liver resection as tumor was small enough to remove, interoperational sonogram identified no other liver lesions.
Treatment: 6 rounds of taxotere, carboplatin completed in January 2006.

Restaging in July 2007:
Dx: 2 lung lesions approx 1cm each
Surgery/treatment: in discussion with tumor board an oncology team.
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Old 11-28-2007, 05:38 PM   #4
SoCalGal
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JUST got back from my dermatologist. We discussed this side effect (chatting in general) and she agreed that usual acne meds don't really work for this "favorable" side effect. For me, I used Tea Tree oil from trader joe's. I dipped a q-tip in witch hazel and then in tea tree oil and by morning the red stuff was gone. Someone on this board posted tea tree oil for skin and nail probs and I found it very effective.
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1996 cancer WTF?! 1.3 cm lumpectomy Er/Pr neg. Her2+ (20nodes NEGATIVE) did CMF + rads. NED.
2002 recurrence. Bilateral mastectomy w/TFL autologous recon. Then ACx2. Skin lymphatic rash. Taxotere w/Herceptin x4. Herceptin/Xeloda. Finally stops spreading.
2003 - Back to surgery, remove skin mets, and will have surgery one week later when pathology can confirm margins.
‘03 latisimus dorsi flap to remove skin mets. CLEAN MARGINS. Continue single agent Herceptin thru 4/04. NED.
‘04 '05 & 06 tiny recurrences - scar line. surgery to cut out. NED each time.
1/2006 Rads again, to scar line. NED.

3/07 Heartbreaking news - mets! lungs.sternum. Try Tykerb/Xeloda. Tykerb/Carbo/Gemzar. Switch Oncs.
12/07 Herceptin.Tykerb. Markers go stable.
2/8/08 gamma knife 13mm stupid brain met.
3/08 Herceptin/tykerb/avastin/zometa.
3/09 brain NED. Lungs STABLE.
4/09 attack sternum (10 daysPHOTONS.5 days ELECTRONS)
9/09 MARKERS normal!
3/10 PET/CT=manubrium intensely metabolically active but stable. NEDhead.
Wash out 5/10 for tdm1 but 6/10 CT STABLE, PET improving. Markers normal. Brain NED. Resume just Herceptin plus ZOMETA
Dec 2010 Brain NED, lungs/sternum stable. markers normal.
MAR 2011 stop Herceptin/allergy! Go back on Tykerb and switch to Xgeva.
May-Aug 2011 Tykerb Herceptin Xgeva.
Sept 2011 Tykerb, Herceptin, Zometa, Avastin.
April 2012 sketchy drug trial in NYC. 6 weeks later I’m NED!
OCT 2012 PET/CT shows a bunch of freakin’ progression. Back to LA and Herceptin.avastin.zometa.
12/20/12 add in PERJETA!
March 2013 – 5 YEARS POST continue HAPZ
APRIL 2013 - 6 yrs stage 4. "FAILED" PETscan on 4/2/13
May 2013: rePetted - improvement in lungs, left adrenal stable, right 6th rib inactive, (must be PERJETA avastin) sternum and L1 fruckin'worsen. Drop zometa. ADD Xgeva. Doc says get rads consultant for L1 and possible biopsy of L1. I say, no thanks, doc. Lets see what xgeva brings to the table first. It's summer.
June-August 2013HAPX Herceptin Avastin Perjeta xgeva.
Sept - now - on chemo hold for calming tummy we hope. Markers stable for 2 months.
Nov 2013 - Herceptin-Perjeta-Avastin-Xgeva (collageneous colitis, which explains tummy probs, added Entocort)
December '13 BRAIN MRI ned in da head.
Jan 2014: CONTINUING on HAPX…
FEB 2014 PetCT clinical “impression”: 1. newbie nodule - SUV 1.5 right apical nodule, mildly hypermetabolic “suggestive” of worsening neoplastic lesion. 2. moderate worsening of the sternum – SUV 5.6 from 3.8
3. increasing sclerosis & decreasing activity of L1 met “suggests” mild healing. (SUV 9.4 v 12.1 in May ‘13)
4. scattered lung nodules, up to 5mm in size = stable, no increased activity
5. other small scattered sclerotic lesions, one in right iliac and one in thoracic vertebral body similar in appearance to L1 without PET activity and not clearly pathologic
APRIL 2014 - 6 YRS POST GAMMA ZAP, 7 YRS MBC & 18 YEARS FROM ORIGINAL DX!
October 2014: hold avastin, continue HPX
Feb 2015 Cancer you lost. NEDHEAD 7 years post gamma zap miracle, 8 years ST4, +19 yrs original diagnosis.
Continue HPX. Adding back Avastin
Nov 2015 pet/ct is mixed result. L1 SUV is worse. Continue Herceptin/avastin/xgeva. Might revisit Perjeta for L1. Meantime going for rads consult for L1
December 2015 - brain stable. Continue Herceptin, Perjeta, Avastin and xgeva.
Jan 2016: 5 days, 20 grays, Rads to L1 and continue on HAPX. I’m trying to "save" TDM1 for next line. Hope the rads work to quiet L1. Sciatic pain extraordinaire :((
Markers drop post rads.
2/24/16 HAP plus X - markers are down
SCIATIC PAIN DEAL BREAKER.
3/23/16 Laminectomy w/coflex implant L4/5. NO MORE SCIATIC PAIN!!! Healing.
APRIL 2016 - 9 YRS MBC
July 2016 - continue HAP plus Xgeva.
DEC 2016 - PETCT: mets to sternum, lungs, L1 still about the same in size and PET activity. Markers not bad. Not making changes if I don't need to. Herceptin/Perjeta/Avastin/Xgeva
APRIL 2017 10 YEARS MBC
December 2017 - Progression - gonna switch it up
FEB 2018 - Kadcyla 3 cycles ---->progression :(
MAY30th - bronchoscopy, w/foundation1 - her2 enriched
Aug 27, 2018 - start clinical trial ZW25
JAN 2019 - ZW25 seems to be keeping me stable
APRIL 2019 - ONE DOZEN YEARS LIVING METASTATIC
MAY 2019 - progression back on herceptin add xeloda
JUNE 2019 - "6 mos average survival" LMD & CNS new single brain met - one zap during 5 days true beam SBRT to cord met
10/30/19 - stable brain and cord. progression lungs and bones. washing out. applying for ds8201a w nivolumab. hope they take me.
12/27/19 - begin ds8401a w nivolumab. after 2nd cycle nodes melt away. after 3rd cycle chest scan shows Improvement, brain MRI shows improvement, resolved areas & nothing new. switch to plain ENHERTU. after 4th cycle, PETscan shows mostly resolved or improved results. Markers near normal. I'm stunned but grateful.
10/26/20 - June 2021 Tucatinib/xeloda/herceptin - stable ish.
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Old 11-28-2007, 07:11 PM   #5
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I have used Bag Balm and Udderly Smooth cream for my hands and feet. I didn't have any luck with my face except to reduce the mg of xeloda to 2000mg/day and tykerb to 1000mg/day. I also now do one week on and one week off for xeloda. My oncologist told me that the greatest benefit from xeloda comes in the first 7 - 8 days. So taking it after that just increases the side effects.

Hope this helps.

Anne
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Diagnosed Jan 2003
Bilateral Mastectomy (right prophylatic) Feb 2003
No reconstruction and no prosthesis - what you see is what you get :-)
6 rounds A/C ending August 2003
Tamoxifen til October 2004
Bone mets diagnosed October 2004
Herceptin (weekly) & Zometa (monthly) December 2004 - June 2007
Arimidex, Faslodex
Oophorectomy October 2005
Rads to left hip November 2005 - December 2005
Zometa quarterly now January 2007
Taxotere December 2005- July 2006
Tykerb (1250 mg) and Xeloda (3300mg) July 2007
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Old 12-06-2007, 05:42 PM   #6
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I started another post about Tykerb rash, but wanted to ask again here, Did anyone get the rash on their legs, arms and torso. It is like mosquito bites and itches like mosquito bites. I am currently using cortisone creme and Amlactin AP. It seems to help some.
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Old 12-17-2007, 10:17 PM   #7
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My doctor gave me a prescription for Clindamycin(sp?). I just turned it in at the pharmacy and I will let ya'll know how it works.
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Old 03-02-2011, 09:59 AM   #8
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Re: Tykerb Rash...help?

Just got told yesterday, severe rash under
breast, torso - I'm off of Herceptin and Tykerb,
until rash cleared up. Glad to be on vacation,
but a little scary. I had a great NED pet scan
with tumor markers cea 0 and circulation 0
and cr27-90 is 19. I just pray alot!

Hope the dermatalogist has some answers......
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Old 03-02-2011, 04:14 PM   #9
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Re: Tykerb Rash...help?

CourtneyL posted her experience (and solution) for Tykerb rash last year:

Yes, I've gotten the rash on by body before. The Suki Serum recommended by someone on here works wonders at making the rash go away. As I recall it was several weeks into Tykerb the first time I was on it, when the rash developed.

I learned something interesting about Tykerb today. According to my onc, it can work later on down the road even if you previously progressed on it. Don't ask me how or why but I think he is right. It did very little for my brain tumors before and now they were shrinking before I even had the Gamma Knife. Of course it could be from the vaccine but you just never know.
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Old 03-02-2011, 08:48 PM   #10
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Re: Tykerb Rash...help?

Hi I am pretty new to this site and check it once in a while for new updates in the field of medicine ect. This is one area I can say I can offer advice because I have had the rash too. I was first placed on Tykerb in adjuvant therapy as part of a study. Broke out in the rash 2 weeks after being on it. It looks more like a case of severe acne - at least for me. My onc was just going to take me off the trial and at the time I thought Tykerb was the latest advance in therapy so I desprately wanted to stay on it. Having been told to always be your own advocate - I went to a dermatologist. She prescribed Doryx and my onc office approved the drug. It cleared up most in a matter of a week and eventually I just went off Doryx and never had a problem afterward. Three months after I finished radiation, I had liver mets so I am now stage IV and in the same therapy as you - Tykerb and Zeloda. One week into the new regimen I started showing signs again of the acne rash. I had left over Doryx and started taking it right away. I went back to the Dermatologist to get more and she recommended using a vinegar wash as well. Sounds strange, but I'm suppose to put vinegar in a papertowel and dilute it with water. Cleanse areas of my body with it before showering it off. I also wash face with Regenerist detoxifying pore scrub (wal-mart has an off brand I use too sometimes) and my face looks much better than other areas like chest and back. But all in all the Doryx really controls it. My dermatologist may switch me to another product closer to summer as she said the Doryx can make my skin sensitive to sunlight. So just a warning there.
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Old 04-03-2011, 03:05 PM   #11
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Re: Tykerb Rash...help?

My Tykerb rash was so bad that my onc had me see a dermatologist the same day. She prescribed Prednisone for 10 days and Protopic and Clobex spray (expensive but she had samples) & OTC Aquapfor & Lubriderm Intense Repair lotion. I had to discontinue the Tykerb until it was cleared up & then restarted. Hope this helps someone.
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Dx'd 9/10; ER+, PR-, Her2+++, 2.8 cm to breast wall right breast; Stage 2 or 3 & involves nodes but has not spread beyond that; clinical trial Tykerb with TC, discontinued for side effects. Surgery w/b removing 2 levels of nodes & tumor. Completed final 2 chemos w/Herceptin. Surgery next.
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Old 05-02-2011, 04:32 PM   #12
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Re: Tykerb Rash...help?

Mom has hive like itchy spots on lwoer leg and tops of feet. is this possible after being on Tykerb (4pills/day) for months? She had some lower leg/torso edema which has gotten much better..but now hives in select locations. She is also on low dose Xeloda and Cytoxan.
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Old 07-17-2011, 05:41 PM   #13
KristinSchwick
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Re: Tykerb Rash...help?

I also suffered from the tykerb rash, 90% of my legs and 30% of my arms. Itched, hurt, burned, miserable. Oncologist suggested topical 1% hydrocortizone, which can help alittle. But what I found most helpful was oral bendryl at night- hard to fall asleep when your itchy. And before bed, an oatmeal bath- Aveno makes a bath additive which is super soothing, oncologist actually recommended that one.

Here's a link to the product
http://www.aveeno.com/skincare/produ...bath-treatment
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[B]Kristin
Aug 2010: diagnosed stage 3b, 4 mo. after birth of son. 29 yrs old and breastfeeding, ER/PR-, Her-2+ started Neoadjuvant therapy: 4x FEC, 10x abraxane & Herceptin
Feb 2011: L mx with recon. Path. showed only DCIS but 4/10+ nodes.
March 2011: 6 wks rads.
Mother passed, lower back pain.
Late May 2011: Bone mets but organs clear; Tykerb, Xeloda, Xgeva. Stopped Herceptin. Implant infected: removed implant.
October 2011: Bone progression; Gemzar and Carboplatin & restarted Herceptin.
Jan 2012: Progression, re-classified as ER+; Tykerb, Herceptin, Zoladex & Femara. Anti-E is working!
May 2012: ovaries out, markers stable but elevated. Cont. Herceptin, Tykerb, Xgeva & Femara.
Dec 2012: aromasin
Jan 2013: faslodex, herceptin, tykerb
Jun: Kadcyla
Aug: Rads to hip, then Perjeta, Herceptin & Taxotere
Nov 2013: Perjeta, Herceptin, Halaven
Early 2014: Affinitor, Aromasin, Perjeta, Herceptin.
June 2014: Estradiol, Perjeta, Herceptin
Aug 14: Tamoxofin, H & P
http://kristin-notdying-blog.blogspot.com/
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Old 07-17-2011, 10:19 PM   #14
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Re: Tykerb Rash...help?

Thanks for the info. I have a hive-like (not acne like) rash on my back and elbows of all things. I will try Aveeno oatmeal bath. Hydrocortisone didn't do much good. Have no idea what Suki Serum is but will investigate.
Trish
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5/2004 (R) 30mm bre gr3 infiltrating ductal ca 16/18nodes er (2+) pr (3+) HER2 (3+)
6/2004
6 cycles(FEC), Oct 40 rads, Tamoxifen
5/2006
oopherectomy, Arimedex
12/2006
liver mets largest 9cm
1/2007
Herceptin,
3/2007
Taxol + Herc
1/2008
Herc alone
4/2008
Multiple bone mets,Zometa
7/2008
Herc + Gemcitabine
8/2008
Herc+Navelbine/vinoralbine
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6/2011
Liver and bone mets prog.Abraxane continue Herceptin,Tykerb,Femara and Zometa
8/2011
Probable liver progression and increased neuropathy. Xeloda with Tyk+Herc. Zometa 6 weekly.
9/2011
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10/2011 liver mets prog.Herc, 3 Tykerb +2mg decodron daily,Zometa
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Old 07-18-2011, 01:41 PM   #15
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Re: Tykerb Rash...help?

I developed the hive-like rash on my arms and some on my back, after about seven months on Tykerb. It feels like bugs are biting my arms all the time, and has gradually gotten worse. Very hard to deal with. I only have one more week on Tykerb, but am now up to 100 mg Vistaril 4 x daily and rx cortisone cream. From reading posts, it seems like there are two kinds of rash with Tykerb, the acne type and the hive type. Rachel
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Old 08-09-2011, 06:25 AM   #16
KristinSchwick
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Re: Tykerb Rash...help?

Trish, How did that oatmeal bath soak help? Did it clear up?
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[B]Kristin
Aug 2010: diagnosed stage 3b, 4 mo. after birth of son. 29 yrs old and breastfeeding, ER/PR-, Her-2+ started Neoadjuvant therapy: 4x FEC, 10x abraxane & Herceptin
Feb 2011: L mx with recon. Path. showed only DCIS but 4/10+ nodes.
March 2011: 6 wks rads.
Mother passed, lower back pain.
Late May 2011: Bone mets but organs clear; Tykerb, Xeloda, Xgeva. Stopped Herceptin. Implant infected: removed implant.
October 2011: Bone progression; Gemzar and Carboplatin & restarted Herceptin.
Jan 2012: Progression, re-classified as ER+; Tykerb, Herceptin, Zoladex & Femara. Anti-E is working!
May 2012: ovaries out, markers stable but elevated. Cont. Herceptin, Tykerb, Xgeva & Femara.
Dec 2012: aromasin
Jan 2013: faslodex, herceptin, tykerb
Jun: Kadcyla
Aug: Rads to hip, then Perjeta, Herceptin & Taxotere
Nov 2013: Perjeta, Herceptin, Halaven
Early 2014: Affinitor, Aromasin, Perjeta, Herceptin.
June 2014: Estradiol, Perjeta, Herceptin
Aug 14: Tamoxofin, H & P
http://kristin-notdying-blog.blogspot.com/
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Old 08-10-2011, 02:34 AM   #17
Trish
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Location: Melbourne, Australia
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Re: Tykerb Rash...help?

Thanks for asking Kristin. The bath certainly soothed the rash but the doctor at chemo simultaneously prescribed the corticosteroid Elocon. I was quickly rash free but am unsure which was effective. Next time my first recourse will be the oatmeal bath and progress to Elocon only if necessary. Hope you are well.
Trish
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5/2004 (R) 30mm bre gr3 infiltrating ductal ca 16/18nodes er (2+) pr (3+) HER2 (3+)
6/2004
6 cycles(FEC), Oct 40 rads, Tamoxifen
5/2006
oopherectomy, Arimedex
12/2006
liver mets largest 9cm
1/2007
Herceptin,
3/2007
Taxol + Herc
1/2008
Herc alone
4/2008
Multiple bone mets,Zometa
7/2008
Herc + Gemcitabine
8/2008
Herc+Navelbine/vinoralbine
10/2008
Herc+Carboplatin+Taxol
12/2008
Tykerb+Xeloda
2/2010
Herceptin + trial drug
5/2010
Herceptin+Tykerb
8/2010
Tykerb+Abraxane
9/2010
Abraxane
12/2010
Abraxane+Tyk+Herc
4/2011
Tyk+Herc+Femara
6/2011
Liver and bone mets prog.Abraxane continue Herceptin,Tykerb,Femara and Zometa
8/2011
Probable liver progression and increased neuropathy. Xeloda with Tyk+Herc. Zometa 6 weekly.
9/2011
Liver progression,TM +++. Cyclophosphamide and Methotrexate metro Herc Zometa
10/2011 liver mets prog.Herc, 3 Tykerb +2mg decodron daily,Zometa
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