Herceptin weekly or 3 week dose?

[Chelee]

I know this has been discussed before...and everyone has to decide what is best for them. But I finally finished my chemo other then weekly herceptin.

I have been told by two different oncologists at my center that they feel getting herceptin weekly is better...but it really makes no difference if I do it weekly, or the 3 week dose.

Has there been any *real* studies done to see if one is better then the other? Where I go to get my herceptin is CLOSE...but it sure would be nice not to go weekly if it really doesn't make much difference? But being stage IIIA, Er & PR positive...I still want to fight this as aggresive as possible.

Can someone point me to any studies that have been done to see if one way is better then another?

Chelee

[CPA]

The three week cycle was the standard protocol in both of the herceptin arms of the BCIRG 006 study presented at the SABCS in 2005.

This study was one of the primary sources used to justify adjuvant herceptin. I am assuming that most oncs will follow the same protocols used in the study because they were shown to work.

I am not aware if there are any studies comparing long term survival with 1 wk v. 3 wk herceptin cycles. Since the BCIRG study is not even through year 4, I doubt any studies comparing the two different administration timeframes are very mature.

The BCIRG study showed that using Herceptin with at least two combinations of chemo gave a better outcome than chemo alone in her2+ cancer patints. I am sure that over the next several years there will be multiple studies attempting to optimize the effectiveness of herceptin and other drugs by administering different combinations, dosages and frequencies.

[Bev]

Hi,

If the thought behind doing Herceptin weekly is to minimize heart damage, my LVF has gone up to levels above all pretreatment while on herceptin every 3 weeks. So hmm, BB

[astrid]

Weekly schedule is: Loading dose 4Mg/Kg IV followed by weekly dose of 2Mg/Kg.



3 Week schedule is: Loading dose 8Mg/Kg IV followed by a dose of 6Mg/Kg every 3 weeks.



It is acceptable to switch between dosing but the loading dose should never be repeated. With the exception of the loading dose the protocol is the same so the same amount of Hercpetin is administered

[CPA]

Since Chelee is on the TCH regimen there should be little or no concern about cardiac damage. Most of the cardiac issues occur when herceptin is used with an anthracycline chemo regimen.

This is why people on a TC regimen can take herceptin while on chemo, but they hold herceptin until after anthracycline based chemo is complete.

[Chelee]

Hi CPA, Thanks for the info on this topic. I was interesting in finding out if there HAD been any studies done in the long term survial of herceptin weekly verses the three week dose. I know I could not find any. Seems you don't know of any either. I suppose it hasn't been long enough for them to do that since herceptin has only been around so long. In time I am sure we will have these answers. (Or so I hope.)

Bev, Thats very interesting and a good point. Actually...I am glad to hear it since I am seriously thinking of going to the three week dosing. Just sounds so much easier. My oncologist just never gives me a straight answer...she says it doesn't really matter. Then I follow up saying I read that weekly is better...then she says it really is. (SAY WHAT!) lol Cant have it both ways.

Does anyone know if that dose for herceptin is done by a persons weight...or does everyone get the same amount? I would think by weight..right?

Chelee

[tousled1]

I had my first Herceptin and was scheduled for the every 3 week regime. I saw my oncologist on Friday and explained to her the side effects I experienced after the Herceptin infusion. She has now put me on weekly Herceptin and it will stay that way until after I finish my rads at which time we will again try the 3 week regime. I asked her if the 3 week was better than the 1 week and she said that getting it every 3 weeks is just a larger dose than getting it every week. In any event she said you receive the same amount of Herceptin.

[Becky]

There is really no difference between the weekly or the every three week regime. Herceptin's half life is 20.8 days so either method is just as good.


Herceptin is done by weight 2mg/kg (of body weight) for the normal dose for weekly. 6mg/kg for the every three week. The loading doses are both 2mg/kg more than than the normal dose.

I started weekly (the first 14) but changed to the every three week because I felt I was always there and I had to leave work every week (not a problem, they are so good to me but I feel there is a limit and don't want to abuse the courtsey).

Kind regards

Becky

[Unregistered]

Hi -
I started every 3 weeks and sometimes go every 2 weeks ... it all depends on my schedule. I feel the 3 week regimen gives me harsher side-effects. Now I am on weekly dose and have no side effects and will be finished in August.

MTS