Doxil w/herceptin. Anyone on this combo or taken this combo?

[cathy34]

Hi,
I got the results from my chest CT on Friday. I have lung mets and I found out that I have NO new nodules which is good but of the 6 nodules that I do have 4 slightly grew and 2 remained the same. My doc wants to switch me from Navelbine w/herceptin to Doxil w/herceptin. Her goal is no growth at all or smaller.
Anyone ever taken Doxil? From what I've read it's for ovarian cancer, but my Dr says it is used for met breast cancer also.

Here's a list of the drugs I've taken over the past 2 years (dx 4/04)...
A/C/T
5 FU
Herceptin
Gemzar
Avastin
Xeloda
Navelbine
and now we'll add....Doxil

I am scheduled to start the Doxil on Aug 5 since my numbers were really low on Friday due to my prior Navelbine treatment and we're taking a family vacation to NC on July 22nd, my Dr said it would be best to start when I returned from our vacation which is just fine with me. I will take it every 3 weeks with herceptin.

I have accepted this as a way of life for me, but it gets very depressing after a while. I don't look sick at all and I feel WONDERFUL - I just hate the ups and downs but it is something I am willling to live with as long as I stay on this earth for many more years to watch my 3 kids grow (I am 38 yo and I have a soon to be 9 yo son, soon to be 8 yo daughter and soon to be 3yo daughter) and I absolutely adore them all.

Any advice on Doxil would be greatly appreciated.

Only positive thoughts,
Cathy 34

Dx4/04
radical right mastectomy 5/04
...continuing the fight daily with the love of my husband and kids

[cathy34]

makes me nervous!

[judiek]

Cathy,


I have not had doxil yet. You didn't metion taxol or taxotere. Taxol and avastin knocked my 5 lungs mets out for about 15 months. Just wondering if your once thought about one of the taxanes...they can be a very effective drug.

Best of luck to you and enjoy that family vacation

Warmly,

Judiek
Mets to lungs/liver

[chrisy]

Cathy, I haven't had doxil, either. There have been some trials with this combo and/or a taxane or platinum. Doxil, as I understand it, is similar to Adriamycin except not as toxic to the heart, so you can use it with Herceptin. You mentioned you have had AC already - if the Adria was a good chemo for you in the past, that may be why your onc would want to try Doxil

Good luck - and LOTS of (only) positive thoughts. It is definitely a balancing act - to be able to live your life with this and stay sane! I'm waiting for my 4-mo scan results which I'll get Wednesday, so I'm a little on edge myself...I always include a request for Bold prayers - no wimpy prayers!

http://www.ufscc.ufl.edu/Patient/cancernews.aspx?section=cancernews&id=36962

http://professional.cancerconsultants.com/oncology_breast_cancer_news.aspx?id=36971

[Sherryg683]

Hi Cathy, I know how you feel. I have an 8 year old daugher and 17 year old son and I HAVE to be around here a long time for them. I had 2 small lung mets. I was put on Taxotere, Xeloda, and Herceptin and they were gone by the first scan, which was 6 weeks after I started the treatment.. I would ask about Taxotere, I believe it's a little harder and stronger than Taxol but it worked for me...sherryg683

[heblaj01]

Cathy,

Based on the high rate of response to the Doxil+Herceptin combo seen in metastatic breast cancer trials it looks like a good choice for metastatic lung lesions (also shown in in-vitro tests).

I am sure there are several other options should the combo not be good enough.

I found this report of a single case of a good response with a different regimen:
Gan To Kagaku Ryoho. (javascript:AL_get(this, 'jour', 'Gan To Kagaku Ryoho.');) 2003 Jun;30(6):879-82.
A case of recurrent breast cancer with lung metastasis and overexpression of HER2 that responded to UFT and cyclophosphamide combination therapy after sequential treatments with epirubicin, taxanes, and trastuzumab]

[Article in Japanese]

Nishimura R (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Nishimura+R%22%5BAuthor%5D), Nagao K (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Nagao+K%22%5BAuthor%5D), Miyayama H (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Miyayama+H%22%5BAuthor%5D), Okazaki S (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Okazaki+S%22%5BAuthor%5D), Nakagawa K (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Nakagawa+K%22%5BAuthor%5D), Fujimura Y (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Fujimura+Y%22%5BAuthor%5D).

Dept. of Surgery, Kumamoto City Hospital.

We describe a 57-year-old woman who underwent modified mastectomy for right breast cancer (T2N0M0) with overexpression of HER2, in whom lung metastasis developed 3 years after operation. She received sequential chemotherapy, including epirubicin plus cyclophosphamide, docetaxel, paclitaxel and trastuzumab, but the lung lesion progressed after transiently showing a partial response. Oral treatment with UFT and cyclophosphamide was begun as fifth-line treatment. The lung tumor shrank after 2 months, and a partial response has been maintained during continued treatment with UFT and cyclophosphamide. No adverse effects have occurred. We regard combination therapy with oral UFT and cyclophosphamide to be useful for the management of metastatic breast cancer, even in heavily pretreated cases with overexpression of HER2.

[Shell]

Cathy-


I'm sorry that I can't add any knowledge to your question, as I haven't had doxil either... I'm currently on xeloda and tykerb, and although I try to remain as positive as you seem, I always feel I need to consider options if my current regime doesn't keep things stable...

As for the other combo mentioned, does UFT or cyclophos... have a more common name for each - I don't recall hearing of them before...

Have a great vacation - ours will be at the end of August at the Jersey shore...

Good luck w/things,
Shell

[cathy34]

I only had one round on Taxol when I started the A/C/T regimin about 2 year ago. I tolerated the first round of Taxol ok. Then came time for the 2nd round and my body just didn't like it! My heart started pounding (I felt like a cartoon character when they show the heart beating outside of the body) within 5-7 mins of the drug starting and my BP shot up to 190/140 and I couldn't breath (they had to give me oxygen) and I broke out in a red flush over my entire body. They immediately stopped the taxol and shot me full of benedryl and the reaction stopped. Of course this happened when my onc was on vacation. So, the covering onc said we'd try taxatere the following week. Well, that reaction was even worse! So, they have classified me as being extremely allergic to any drug in the taxane family. So, when my onc returned she said since we couldn't continue with the taxol that she would use what they used to use before taxol which was 2 more rounds on A/C along with 5FU. I think everyday being allergic to the taxol has really screwed me! However, as my Dr constantly tells me she's not going to kill me trying to cure me. I can buy that :)

I hope I can tolerate the doxil. They give it to you slow during the first round - 90 min drip, but with my track record she said she would do it over 2 hours.
I think during this journey, I found out that I am allregic to more meds than I ever thought.
I'm allergic to ... Zofran, Keflex, ALL cyclosporaines, penicillin, ALL taxanes, another anti-naseau drug that starts with an "A" (I have it written down).

Thanks for all your responses.

[MJo]

Cathy

I've been an asthmatic since age 3 and have lots of allergies. I was terrified about allergic reactions before treatment started. Taxols and taxanes are made from ewe trees. Boy, was I afraid of having an allergic reaction, since I'm allergic to a lot of trees. I was lucky. I'm allergic to penicillan too. I actually went into anaphalaxis. That's why I was so paranoid about having an allergic reaction during treatment, and I told the nurses so. In fact, when I had my first taxol, they didn't tell me when they started the infusion until it had been going 25 minutes, because they knew I might have a panic attack.

You made it through Adriamycin and Herceptin. You have a great husband and kids who need you (sigh. I don't have that advantage). We have Tykerb now, which apparently has even fewer side effects than Herceptin. If we have to have this d*&)&) Her2 disease, at least we have a good chance now. Five years from now treatment will be even better. I trust that we'll both be around and NED to see the cure.

Much support.....Mary Jo