Should "Late" Herceptin Users Also AddTaxol?

[Barbara2]

There are so many of us who did not receive Herceptin and or Taxol during our first course of treatment, for various reasons. Some of us have decided to ask for Herceptin even though we are more than 6 months out of treatment.

Are any of you planning to add Taxol to the Herceptin, if you didn't receive it in your initial treatment? The recent results from the Herceptin trials showed fewer recurrances when Herceptin was combined with Taxol.

This summer I have given a LOT of thought as to what course to take, and still have not made a final decision as to what to do: take Herceptin alone, or add the Taxol. Here is my picture:

Oct 02 mastectomy, Her2+ 8.7
Grade 3, Stage 2b
4.5 cm tumor
1 positive node
ER+10%, Pr-

Treatment: CEFx6, finished in March 03, Arimidex to follow

This past May, I asked for and received Herceptin. I've had 13 (weekly) treatments so far. My oncologist and I have discussed whether or not Taxol should be added. He said he would give it to me, if that is my desire. There is no proticol to follow in this situation, so "when" to add the Taxol, is not an issue.

The bottom line is, no one knows if at this late date how beneficial Herceptin will be, much less if to throw Taxol into the mix. I was scheduled to add the Taxol to tomorrow's treatment, but then I called to cancel the Taxol. I thought I was mentally ready to do it, but I guess that wasn't the case.

If you are in the "late" Herceptin catagory, would you please take a minute to reply as to what your choice was? Even something brief would be appreciated. Thanks so much!

Barbara2

[jjfromcanada]

I didn't. None of the oncs I talked to suggested it, but I am nearly 3 years out of chemo.

I had CEF and one onc specifically described it as "good chemo" for HER2.

I did not point out I thought that was an oxymoron.

[*_Cynthia_*]

Barbara,

I recently found myself almost precisely where you are now. I was dx 9/03, bilateral mastectomy; 4+ nodes; er+/pr+; Her2 +++; CAF x6 finished 4/04; rads finished 7/04; vaccine trial; NED to date.

I asked my onc about Herceptin after the ASCO meeting. She said no because I was more than 12 months out. My second opinion onc said yes to Herceptin because of my high risk status and suggested I throw in some Taxol for good measure because of the demonstrated synergy between Taxol and Herceptin. Talk about two ends of the spectrum. I informally polled some onc. Herceptin experts and found that one said do nothing, two said do Herceptin alone, and one said do Herceptin and Taxol. So when I added my two opinions to these suggestions, we had a three way tie. Gee, that was helpful. Thus, I had no choice but to figure out all by myself what I would do.

While I initially opted for Taxol + Herceptin in order to get the biggest bang for the buck, I just couldn't get comfortable with that decision. My quality of life right now is great and I didn't want to undergo chemo again in the absence of known disease. I didn't want to deal with low white counts, the loss of my hair after finally getting it back, and neuropathy risks associated with Taxol since I have a history of pretty nasty neuropathy. But was I wimping out and risking mets that I might otherwise thwart if I just sucked it up and have them throw the book at me now with Herceptin and Taxol? I flip flopped back and forth and ultimately opted for the Herceptin only approach. If and when I need Taxol or anything else, I will get it at once. But while I am NED and after recently undergoing some pretty aggressive treatments, I want to maximize quality of life with my husband and three year old daughter and will just stick to Herceptin for now. I am getting treated once every three weeks and have had no problems with Herceptin to date.

I am very comfortable with my decision which suggests that it is the right one for me. Given how little is apparently known for us far out/previously Taxol-free gals, I think that you need to make the decision that feels right to you (if you think you would beat yourself up if you get mets down the road for not taking the Taxol now, perhaps you should just do it). Tough stuff, I know.

Best of luck and good health. Please let us know what you decide.

Cynthia

[LindaBL]

Cynthia:

I appreciated your reply. I also decided to do Herceptin alone. I didn't want to deal with the potential Taxol side effects. My oncologist did not think Taxol would be helpful at this time but said if I wanted it, he would do it for me. Also, I was node negative and in 2002 Taxol was not standard treatment.

If I was diagnosed today, I would definately do Taxol but think I am too far away from my original treatment to get much benefit now.

Diagnosed Sept. 2002 with 2.4cm IDC, node negative, ER+, PR+, Her2+++

Treatment: ACX4(finished Dec.2002), radiation, Arimidex, Herceptin every three weeks (started June 2005)

Linda

[christine-OZ]

I will be getting herceptin late having finished my chemo May 04. I will not be asking for Taxol as i am NED. As you said, hard to put yourself through it again when you have got back your quality of life, hair etc. My Dx: tumor at least 2.3cm( don't know for sure as you couldn't see it on xrays etc and i had three ops and they kept cutting into it) mastectomy, 3 nodes ER+,PR+, HER-2+++. i had 8 rounds of FEC which no-one else seems to have had. I am currently on Tamoxifen but always ask onco if i should change to AI. Grade 3, stage 2b( i don't think you have 2b in America)
Are you in Australia Barbara2?
Regards
Christine

[Barbara2]

No, I live in the United States. Yes, we do have a 2b staging for breast cancer. So far in these replies, no one has opted for adding the Taxol which could be a choice, even when NED.

Are you postmenopausal? If so, you could have the hormonal therapy drugs, if not, your oncologist would want you to have Tamoxafin.

Wow! 8 treatments of CEF sounds like a lot. The 6 I had were very tough on me.

Best wishes, Barbara

[CHRISTINE-OZ]

when you asked if i was post menopausal(which i well and truely am after have my ovaries out), i didn't understand the rest of your statement/question. I am on Tamoxifen. Which are the hormone therapy drugs you refer to?
Thanks
Christine

[Barbara2]

Sorry it took me so long to reply........


Arimidex is for postmenopausal women with hormone receptor-positive early breast cancer. In a large study of women in this catagory, Arimidex significantly reduced breast cancer returning compared to Tamoxifen. Premenopausal hormone positive women must receive Tamoxifin.

If you are truly postmenopausal, you may want to discuss this with your doctor.

Best wishes, Barbara2

[Christine OZ]

thanks Barbara. It is actually a question i have asked many times but last time we got waylaid by the Herceptin issue for control group of HERA. I have investigated this topic a bit and been to lectures etc. I will ask again tomorrow as i see him then. I have my shopping list of questions ready!!
Christine