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08-02-2007, 02:42 PM
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#1
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Senior Member
Join Date: Sep 2005
Posts: 95
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Interesting Trial -- Drug Crosses Blood Brain Barrier
Friends,
There seems to be way too many folks on this site with brain mets. I recently posted on this topic, but wanted to do so again to keep this issue fresh. There is a very early clinical trial involving Vorinostat (also known as SAHA) + Herceptin for B/C patients with metastatic disease. While this trial is not focusing on brain mets specifically, having had brain mets does not exclude you from the trial if they were previously treated with WBR and they are stable. The interesting thing to me about the trial is that Vorinistat has been shown in other studies (mice models and humans with giloblastomas) to cross the blood brain barrier.
So far, only nine patients have been enrolled on this trial, though it is just now rolling over from a Phase I to a Phase II. While it should open around the country as an ECOG multi-center trial in about six months, it is currently only available at two sites: one in Philadelphia and one in New York. If you are interested, I can give you the the principal investigator's contact information. You and/or your doctor can contact her directly about the trial.
Here is the www.clinicaltrials.gov link for this trial: http://clinicaltrials.gov/ct/show/NCT00258349
Here is an article published by Mayo regarding the use of Vorinostat with recurrent glioblastomas: http://www.mayoclinic.org/news2007-rst/4082.html
Finally, here is an article about the use of Vorinostat in the mice model:
http://www.researchgrantdatabase.com/1Z01BC010538.html
Sorry, Joe, I know this really belongs on the Clinical Trials section -- and I am posting there as well. I just want to get the word out on this.
Please understand I have no personal experience with this trial other than to be aware of its existence. I am, however, intrigued with the very early data relative to Vorinostat's proven ability to cross the BBB and attach brain cancer -- albeit in another form of brain cancer and in mice models.
If you want contact information for the principal investigator, please email me at clgilman1@yahoo.com
Stay well.
Cynthia
__________________
Cynthia
Diagnosed 9/03 @ 43 years (pre-menopausal)
Her2+++
4 nodes +; High Grade
ER+/PR+
Bilateral Mastectomy; Reconstruction
CAF x 6; Radiation; One Year Late Herceptin
Oophorectomy; Arimidex
Completed E75 Vaccine Trial; Completed E75 Vaccine Booster Series
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08-08-2007, 01:09 PM
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#2
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Senior Member
Join Date: Sep 2005
Location: Philadelphia
Posts: 301
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Cynthia-
I'm in Phila - could you send me more info about this?
Kind regards,
__________________
Shell
init diag 3/17/03-stage IIIC
ER-/PR-/HER2+++
CET x4 neo-adjuvant
lump & SNB 8/03
CET x2
radiation and herceptin/navelbine 11-03-1/04
1st reoccur to lymph nodes 8/04
complete axillary dissection 12/04
herceptin/taxotere til progression (lungs) 3/05
xeloda w/out lapatinib trial 6/05
lapatinib/tykerb added 4/06
ended trial 8/06 due to progression
doxil / avastin 11/06-12/06 - wasn't working
navelbine/herceptin/avastin 12/06/3/07 - progression
gemzar/carboplatin/tykerb 4/07
mri shows extensive mets to bone in pelvic area 6/07
switched to abraxane (3 on/1 off) + tykerb 6/07
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08-08-2007, 04:11 PM
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#3
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Senior Member
Join Date: Oct 2005
Posts: 3,519
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I am just posting this as another perspective regarding brain mets...
FYI, Xeloda and Carboplatin are two chemos that are small enough molecule to cross the BBB and of course, Tykerb is the current monclonal that crosses... I am my own personal clinical trial regarding Tykerb/Xeloda as my doc agreed to let me hold off on WBR or any rads for a time while we scan regularly and see what T/X will do. So far, my brain mets showed stable on the MRI (with one of the 9 mm spots less enhanced) 6 weeks ago after a month on T/X and we will know more next week when I have another MRI. My TMs have dropped like an anvil from 45 to 9 in 2.5 months. I am still asymptomatic, and doing great. I am not recommending this brain mets course for anyone else as it was specific to me and I negotiated it with my onc. I will report my progress as we know more.
__________________
Brenda
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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08-08-2007, 10:53 PM
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#4
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Senior Member
Join Date: Oct 2005
Location: southern california
Posts: 287
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I wasn't aware that Carboplatin crossed the blood brain barrier. I had carbo/taxol/herceptin in a trial and am NED for 18 months now. I do have 5mm nodules in the lungs but it is not confirmed as carcinoma. It is assumed to be scar tissue as it has not progressed. It is good to hear that there are more alternatives concerning the blood brain barrier.
Alice
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08-09-2007, 12:12 AM
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#5
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Senior Member
Join Date: Oct 2005
Posts: 3,519
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I didn't know about Carbo either until I was diagnosed with brain mets, and I asked my doc what chemos crossed the BBB and he said definitely Carbo and Xeloda. Don't know what that means in the grand scheme, but I believe it probably helped me keep them at bay for the time that I was on it...
__________________
Brenda
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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08-09-2007, 07:44 AM
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#6
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Senior Member
Join Date: Jun 2007
Location: RHODE ISLAND
(Ed getting me a latte on 2nd Cancerversary Cruise 2008)
'BELIEVE': To accept as true or real, To have faith in, To presume
ALWAYS BELIEVE
Posts: 2,999
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Thanks Cynthia
Thanks for sharing this information it is very much appreciated and more ammo for my husband's journey with breast cancer. Since it is such an unpredictable disease we have always embraced learning all aspects of this illness. This board has been such a lifesaver for us during this rather horrific time in the journey called our life, a life we have always referred to as our 'Fairy Tale'. And by the way, we refuse to let breast cancer steal away our fairy tale!!!
Thank you for making us aware and providing us with knowledge, love, and hope.
ALWAYS BELIEVE!!!>>Believe51
__________________
9/7/06Husband 50yrs=StageIV IBC/HER2+,BoneMets10/06TaxotereX10,'H'1X wk,Zometa,Tamoxifen4/12/07Last Tax5/18/07Pet=Rapid Cell Activity,No Organ Mets,Lytic Lesions,Degeneration,Some Bone Repair5/07ChemoFail6/01/07Pleural Thoracentisis=Effusions,NoMalignantCells6/19/07+7/2/07DFCI
6/25/07BrainMRI=BrainMets,Many<9mm7/10/07WBR/PelvisRad37.5Gx15&Nutritionist8/19/07T/X9/20/07BrainMRI=2<2mm10/6/07Pet=BoneProgression
10/24/07ChemoFail11/9/07A/Cx10,EndTam12/7/07Faslodex12/10/07Muga7512/13/07BlasticLesions1/7/08BrainMRI=Clear4/1/08Pet=BoneImprovement,
NoProgression,Stable4/7/08BrainPerfect5/16/08Last A/C8/26/08BrainMets=10(<9mm)9/10/08Gamma10/30/08Met=5mm12/19/08Gamma5mets5
12/22/08SpinalMets1/14/09SpinalRads2/17/09BrainMRI=NoNewMets4/20/09BoneScan5/14/09Ixempra6/1/09BrainMRI=NumerousMets6/24/09DFCIw/DrBurstein6/26/09Continue
Ixempra/Faslodex/Zometa~TM now lower7/17/09Stop Ixempra By Choice9/21/09HOSPICE10/16/09Earned His Deserved Wings And Halo=37 Month Fight w/Stage 4 IBC, Her2+++,My Hero!!
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08-09-2007, 09:35 AM
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#7
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Webmaster
Join Date: Feb 2005
Location: Home of the "Flying Tomato"
Carlsbad, CA
Posts: 2,036
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Details of this and other trials are on our featured trial page:
http://her2support.org/index.php?opt...d=52&Itemid=75
Regards
Joe
__________________
A Proud webmaster to the internet's most informed, educated, COMPASSIONATE and caring group of breast cancer survivors.
Illegitimi non carborundum
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