Adjuvant Taxotere/Platinum Salt/Herceptin after dose-denseAC

[vinnie]

My wife has been dx'ed with Stage IIB IDC,ER/PR+,HER-2+,3nodes +. She is 36.

Do you all think adding a platinum salt to taxotere/herceptin is going overboard in an adjuvant setting after dose-dense AC. She will have her last dose-dense AC cycle next week.

The BCIRG 006 does this combo, but it is not after AC especially not after dose-dense AC.

Has anybody else done this regimen? What are the risks of adding platinum salt to taxotere/herceptin in an adjuvant setting?

Thanks

[Leslie]

I had 4 rounds of AC, followed by 6 weeks of radiation, followed by 4 rounds of Taxotere with weekly Herceptin. When I was done with the Taxotere, I told my oncologist that I could handle more chemo if it would be beneficial. He said that there was no evidence that more would be better and that in the long term, all this chemo could deplete my bone marrow and cause leukemia. It was ironic because the day before, a friend of mine had died from leukemia. He got leukemia 10 years after finishing heavy treatment for colon cancer.

[vinnie]

Leslie

Just curious why you did radiation after AC. Did you do taxotere/herceptin combo weekly or every three weeks

Thanks

[lauren]

Radiation is an option for women with positive nodes, particularly women with four or more positive. I had two positive (maybe three, actually), but they thought it was a great idea to do radiation.

[vinnie]

Sorry, but I meant why radiation after AC instead of taxotere/herceptin after AC and then radiation after that. That's the order I have usually seen.

[lauren]

I guess I wasn't clear. Here is my timeline:

Sept 2002 double mastectomy
Oct 2002 through March 2003 - 12 weeks of AC, every 3 weeks, followed by 6 weeks of herceptin and taxotere, every week, followed by 6 weeks of herceptin and taxotere, every 3 weeks.
March 2003 through March 2004 - Herceptin, every 3 weeks.
May 2003 through end of June 2003 - 6 weeks of radiation (one week was scar boosters).
June 2003 through present - Arimidex

See? I had radiation AFTER all my chemo (not counting herceptin alone)

[Leslie]

I needed radiation because I had 13/15 lymph nodes positive. My oncologist had agreed to give me herceptin off trial and follow the acth arm. But, after I finished AC, he got concerned because I have a strong family history of heart disease. So, he decided to send me for radiaton before starting Taxotere/Herceptin. I receive Taxotere every 3 weeks, and Herceptin weekly. He would only give me 6 months of Herceptin, his reasoning is that they don't know the long term side affects and I don't have evidence of disease.

[Leslie]

From what I understand, cancer cells can lie doemant in our system for years. Chemo only destroys active, fast growing cells. So, a large amount of chemo in the adjuvant setting will probably not be more effective. Our bodies can only tolerate a certain amount of chemo, so the goal of the oncologist is to aggessively treat our cancer, but not destroy our bodies so that we can't fight a reoccurence if that should come.

[Lyn]

Hi Vinnie, the chemo, rads, chemo is called sandwhich therapy, meaning the chemo attacks the cells in the blood, the rads attack the cancer cells that may have spread by surgery and the last chemo for anything else that got away, but obviously not concrete because we all still seem to get it back. I am on Hercpetin/Taxol/Carboplatin and they are proving that adding the platinum drugs help the taxens work better, before the taxol was added to my drugs the platinum, carboplatin just stalled the disease but now it is going again. I had taxotere on its own after AC, rads, CMF, femara and the taxotere only worked for a month after I finished. Then I went on Xeloda, Aromasin and then Herceptin/Navelbine which still let one get past.



Hugs Lyn

[Christine]

Vinnie
Iwould rather take any of the platin drugs, especially Carbo and Cisplatin , that has been proven in the early trials to be the most effective combo with Herceptin. A/C can end ip to be a futile and harch adjuvant therapy, as it does not perform well and can be insensitive to the Her2 overexpressing cancer. I and other stage 4 patients have been through A/C and the disease progressed . I had been scheduled for 4 cycles and asked the Onc. to stopafter 3 and go on to the next line of therapy, Herceptin/Taxol. It worked for me in 4 days and I was feeling exceptionally improved.I had plurel effusion left side and it progressed onA/C.
Well wishes to tou and your lovely wife

[lauren]

Christine,

The trial arm that used carboplatin did not use A/C, so I did not want to go for it - my onc still believes that A/C is the proper chemo to start with for any aggressive cancer. She is at Columbia. I really don't think she would have recommended it if it were "futile".

lauren

[jojo]

If the early trials did show appropriate data (according to Christine's post stated above), then you ladies had better watch your response rate while on A/C (dose dense or not).

I was originally dx'd at stage 3B last year. I did respond to dose dense A/C, but I think my response was even better after I had started weekly Taxol/Herceptin. I would guess that Herceptin played a larger role this time around.

By my 4th or 6th Taxol, the radiology dept was surprised that they couldn't seem to find my primary tumor via ultrasound, in preparations for inserting a metal clip. It took them about 2 hours before the head rad doctor then determined that it was mostly calcifications, and that the tumor seemed to disappear, and that I did not need the clip, after all.

Then, after all my chemo fight, my surgery path reports indicated what the rad dept had correctly guessed: the primary tumor totally disappeared (around 6-7cm in the beginning).

That is the only good news I got out of surgery results, other than 17/18 positive nodes....

[JoJo]

PS: I was neoadjuvant.