Weekly versus 3 week Herceptin dose studies

[whatsup]

Hello:

Kim here - Stage III bc'er who has finally completed the chemo and rads this June. Now, I would really like to go on the 3 week dose of herceptin. I've been doing weekly herceptins as onc didn't want to do 3 week dose with rads. My echo is fine - however, nurse says I'll need to show onc studies that show same results with 3 week dose in order to go off of my weekly schedule.

Does anyone know about this type of study? I know that they recently came out with a study showing that herceptin with radiation did not cause any more probs to the heart.

At any rate, any help would be GREATLY appreciated.

much thanks!
Kim

[Chelee]

Hi Kim, I am interested in the question you asked also. I have heard it both ways. That weekly IS better...but then again I have been told it really doesn't make any difference.

I would love to know if there is any actually data that shows which is better? I am on my 2nd oncologist and they both said weekly was better....but yet they don't care if I go to every 3 weeks. I don't know if they think weekly is better because maybe its easier on the heart? I really don't know. I hope someone here has the answer to this.

Chelee

[tousled1]

You get the same amount of Herceptin whether you are on the 3 week or every week cycle. If you are weekly the 3 week dose is just spread out.

[dlaxague]

Kim, if you contact Genentech they'll send you information on the studies that have been done looking at dosing interval for Herceptin. The ones they sent me are about weekly vs. q3weeks in metastatic disease. Not sure if they have them for adjuvant treatment, but try asking. They were very helpful, returning my email with a phone call and then sending the documents right away (email attachments). Just google Genentech and look for patient assistance or something like that, fill out a short form, and they'll help you.

Debbie L.
PS: does anyone know how to change the name (not the signature) that appears with your post? I don't like having my whole email address up there, but can't remember how that happened, and can't find options to change it.

[sarah]

I'm certainly no expert but I would think that since you have to be at the hospital every day to get the radiation, getting weekly doses of herceptin during radiation wouldn't be a burden and I think anything taken in smaller doses would be gentler on the system. I think most of us take every 3 week doses because we want some freedom. I'm hoping for the pill form to work! Just my opinion.
sarah

[Sherryg683]

My Oncologist told me that he has seen better results with the weekly doses and was a little disappointed with the 3 weekly, didn't ask him to elaborate. I have mets (that are currently gone), and he wants to keep me going every week because it seems to be working so well...that's fine with me. I live about 5 minutes from my treatment center so that makes a difference...sherryg683

[IRENE FROM TAMPA]

My onc. decided to keep me on weekly Herceptin - her thinking, that it would not be such a big hit of the drug at one time, thus less strain for the heart.It made sense to me. Since then, whatever treatment I am on, we break it down into weekly treatments and it keeps something constant.

That was her theory so I thought it made sense and we kept it that way.

Like I mentioned, this was her opinion and nothing has come out to say it is true so whatever works, keep doing it.

Good luck

[Sandy H]

My oncologist says he feels the weekly is more balanced and works better as well as easier on the heart. He did say if I wanted to go every 3 weeks he would be o.k. with it or if I had to travel a long way to get to the clinic . He did not mention any studies to back up what he told me and usually he will say, "according to such and such study its this way". I opt to stay weekly because its not that inconvenient for me to go in every Friday morning. hugs. Sandy

[whatsup]

THANKS everyone! I had not thought of contacting Genetech, I will do that. My nurse who has been an angel was very, very firm that she didn't seem like the 3 week dose was happening for me w/out a study to show the same or better results.

Like most of us, I REALLY want some distance from the hospital. It's not that everyone isn't great and wonderful - they are! I mentally would really, really like the break. However, it does not seem like that will be my situ . . .

I've pulled heaven and earth to keep my job during tx - which means ALOT of very early am appts and getting up very early to get to work to work my normal hours in addition to going to the docs all the time. I was off for 6 months, but went back to work very soon after surgery and my first post-surgery chemo. I worked through all the other post-surgery chemos and rads. So, it's a toll physically on me to manage all of these appts with work!

I think the solution is going to have to be Sat infusions as I requested immediately but was denied that. The nurse seemed more open to that now.

[Chelee]

I know this was "Whatsup's" thread...but I had a question about this same thing. Seems most of you all made good points about the weekly herceptin.
Plus I noticed some of you said your oncologist all felt the results were better with weekly. I did ask my 1st oncologist about this when I first started herceptin...and I have also asked my current onc doc. They both said the same thing...the felt weekly is better.

I decided to stay on my weekly herceptin. It only takes me 7 minutes to get to my cancer center...and if I do rads...I will HAVE to be there anyway. Its just Mondays will be a longer day for me with the herceptin and Rads.

The infusion nurses were sure pushing me to go for the every 3 weeks? Humm?

[Chelee]

I know this was "Whatsup's" thread...but I had a question about this same thing. Seems most of you all made good points about the weekly herceptin.
Plus I noticed some of you said your oncologist all felt the results were better with weekly. I did ask my 1st oncologist about this when I first started herceptin...and I have also asked my current onc doc. They both said the same thing...the felt weekly is better.

I decided to stay on my weekly herceptin. It only takes me 7 minutes to get to my cancer center...and if I do rads...I will HAVE to be there anyway. Its just Mondays will be a longer day for me with the herceptin and Rads.

The infusion nurses were sure pushing me to go for the every 3 weeks? Humm?

Chelee

[janet/FL]

My oncologist gave me the choice of weekly or everythree weeks of Herceptin followoing the weekly Taxotere/Herceptin (that I demanded as he was going to go every three weeks) My new oncologist is the one that gave me the choice with the Herceptin saying, I think, that the studies done in Europe were every three weeks and in US every week with no differnece. Now, Kim, lets see what the Genetech says!
Janet

[mts]

I started with every three weeks but I felt that the large dose was making me feel a bit nauseated. I tolerated the queeziness for almost 6 months until I finally said to my onc that I could not stand it! He said no problem- every week is fine. I am MUCH better regarding the side effects. I have also had the Herceptin every two weeks for a few months when I was on vacation... that seemed to work fine. I understand that weekly is better for more advanced cancers. Yet, there are ladies on this site who do have advanced cancer and take the Herceptin every 3 weeks. In the end, I think the dose is just as well either way you go. The only difference are the side effects...


Maria (MTS)

[panicked911]

herceptain stays in the body for three months after the last dose - every onc in NY I have seen says it makes no difference 1x vs. 1 every three for adjuvent. However - on the studies that were done with radiation , herceptain was given weekely and it showed that the rad treatment for hers + was more effective with the herceptain hence since the study was done with 1x per weeks oncs folo the 1x per qweek protocol during rads.
I switched to 1 every three 3 weeks after rads werwe ovwer ( radition stays in your body fopr 3 weeks) and the side effects were worse. I still refuse to switch back becuase the process takes so much of the day to adminster the Iv. will deal with the 5 more rather than the 15 more. Hope this helps


Susanne

[RhondaH]

http://www.gene.com/gene/news/press-releases/display.do?method=detail&id=4661&categoryid=4

Rhonda

[heblaj01]

I would like to mention the remarkable repeated succes by Gina in regressing 4 times her liver mets over 4 years of interrupted & resumed Herceptin treatments at various doses escalated when necessary depending on the size or number of the mets.
She is attributing this repeated succes to the fact that the relatively high number of high initial loading doses increased the chances of suppressing more HER receptors.
If this is true then the every 3 week IV which is usually a higher dose than the weekly infusion may carry a small advantage in spite of the fact that over time the average dose is the same in the two regimen.
Of course all this is pure speculation not proven fact.

[whatsup]

Hi there:

I talked to Genentech today. They could only share little with the patient - basically that Herceptin is ONLY fda approved for mestatic BC patients and only for 1 week doses. SO, no info there. They said that only additional info on current studies would be given to my health care provider who would need to call directly.

SO, my brother did an amazing search for me and it really looks like 3 weeks is FINE. I will not push though and ask my onc what her sincere opinion is on this. I don't think the nurses are comfortable with the 3 week dose yet, so I can't ask for something that is out of my domain. Also, I'm a major stage III'r - doing GREAT, but they may be taking more precaution with me becuz of that. I don't know.

Thanks ALOT for your help. Looks like this is a question for almost all her2nue+ patients.

Kim

[Chelee]

Whatsup, It is interesting how things are so different depending on where one lives. My onc doc will say that the weekly is better...however they won't elaborate on why? And they always go on to tell me 3 wks is fine too...and its up to me.

Now the infusion nurses...they really PUSH you hard to go to the 3 wk dose! They say most all of their herceptin patients do it every 3 wks. (I started thinking maybe the nurses like it that way because it keeps the infusion room from getting so backed up. That place gets pretty busy.

Since I finished my full cycle chemo....they have all been on me to go to the 3 wks dose. The oncologist here all say its fine. Seems no one cares...and its up to us which way we want to do it.

I have been doing mine weekly since day one since I am a serious stage III person. I was thinking of changing to the 3 wk schedule since I was going to start Rads...as it would be one less thing for me to do. So I had called last week to warn my infusion nurse that I might want to do that this Monday. (7-17-06). Well...after reading the posts over the weekend about weekly rads working better with herceptin...and how the 3 wk does can be harder on the heart while doing Rads...I CHANGED my mine and decided to stay on the WEEKLY. Plus if I am going for Rads I will be there anyway to do my weekly herceptin...so I was going to leave it as is.

That back fired on me. I went in today for my WEEKLY herceptin & my infusion nurse had already got the OK to mix my herceptin for the 3 wk dose! ARGH. I told her I am sorry...but I want to STAY with the weekly. I said did the pharmacy already make up my IV bag for the 3 wks? She said "Yes." But she did say it was ok...she could change it..for me not to worry. I felt bad since I WAS the one that called her last week to go to the every 3 weeks...so I said to just give it to me that way.

So today against what I had planned on...I DID get the 3 wk dose this time & now I read that Radiation works BETTER WITH WEEKLY herceptin. (Darn...I can't win!) I am a stage III person...so thats why I was sticking to the weekly. I can't blame them since I did call to inquire about it last week. But I am due to start rads...I am stuck now. Whats done is done. :(

Whatsup...that is funny how your infusion nurses aren't comfortable with the every 3 wks...yet mine PUSHES you to do it that way. (I can't help but think WEEKLY is better.) But who knows?


Chelee

[Muldoonmom]

I've been on weekly herceptin for 7 years! My onc and I have talked a few times about switching me to every 3 weeks but I think we just feel that if it ain't broke, don't fix it! I'm on weekly Gemzar also so I would still have to go to the doc's office every week for tx.
I'm on a very short leash but if I plan a trip to visit my daughter and beautiful granddaughter - he gives me a week reprieve.
We're now looking into tykerb - but if it means going off herceptin, I'm not too sure if I'm willing to do so now.
Take care and keep fighting!

[Bev]

Hi all,

I've been on the once every 3 week plan, thru rads. No side effects. LVF has gone up since before chemo. I don't know what's more effective. Reading posts, I do see that some tx is more common in different geographic regions. As has been said before. we're still writing the book. BB

[fitztwins]

I did every three weeks. The benedryl knocked me out, but other than that, I had no issues and enjoyed (if you can call it that) the schedule. I have a 40 minute drive and needed to take off an afternoon. I did dose dense initially. My oncolgist said there were only slight difference.

It is so interesting to me that even our onc. differ on things.

[Barbara H.]

I have received it every 3 weeks for two years at the Dana Farber in Boston. It completely knocked out liver and lung mets without other chemo. Unfortunaely, mets have now started up in the bones and I had to add Navelbine. I prefer every three weeks, and my oncologist told be at the time that it was just as effective to get it every 3 weeks.
Best,
Barbara H.

[Unregistered]

Hi all,

I'm writing on behalf of my sister-in-law who is located in Germany and has Her2-neu BC. she's on chemo right now, her onc started giving her Herceptin (and for the ones that don't know it - the Herceptin is now also allowed for bc without metastases - thank goodness) with taxotere. I'm still trying to find out all the details - darn time difference drives me crazy besides the point that I can barely talk to her because she's not feeling too well. Her leukos went down to 1700, I believe when they reach 1000 she'll get hospitalized.

I'm curious about your experiences with the Herceptin and the taxotere (and no - I have not found out yet whether she receives the weekly or 3 week dosis, like I said - her first treatment was July 13th and ever since can't get in touch with anyone over there). She's feeling very weak, bone pain, and gets morphium against the bone pain. What I don't understand and my brother emailed me - the pain and the low leukos may be due to the taxotere which she receives in 4 "units". I don't understand it but he didn't elaborate either. Any clues??