taxol & avastin - starting next week

[Pam P]

I will be starting weekly taxol & avastin every other week. I'd like to hear from others who have experience on this. I have bone mets and also get aredia 1 time a month.

I am just discontining xeloda. I've been on xeloda over 3 1/2 yrs, 1st with herceptin, then with tykerb. This worked so well for me for a long time. The hand/foot issues were hard at times, but all in all I didn't really feel like I was on chemo.

I'm really dreading having to go back to a harder chemo regimen, the weekly IV sessions, losing my hair, etc. I work full time & am worried about being able to feel good enough to maintain reasonable work schedule too.

I have bone mets. My CT/PET & CT scans last month were stable, but my ca2729 has risen steadily for last several months. Latest was 603, up from about 200 last fall. So my dr. thinks I need to switch meds.

I appreciate knowing what others think & your experience with taxol & avastin. I had 4 tx with taxol in my initial chemo and recall the bone/joint pain & neuropathy for me was really painful.

Thanks. Pam

6/2001 - dx IBC, ER+, HEr2+
mastecomy
chemo: 4 ac/cytoxin & 4 taxol, followed by rads to chest
2/2002 - tamoxifen
9/2002 - bone mets - femara & aredia
1/2003 - taxotere & herceptin & aredia
6/2003 - faslodex & aredia
1/2004 - navelbine & herceptin & aredia
1/2005 - herceptin & aredia
7/2005 - xeloda & herceptin & aredia
3/2007 - xeloda & tykerb & aredia
5/2008 - starting taxol, avastin & aredia

[Mary Anne in TX]

Pam, I haven't taken Avastin, but I've riden the Taxol train. It is tough, but you make that trip with your head high and your heart determimed to take it one day, one treatment at a time. Those crumby mets just better get out of the way. The heavy duty stuff is on it's way. Really, Pam, I'm praying for you and believing that your journey will be smooth and filled with ever decreasing tumor marker scores. The very best to you, ma

[Sheila]

Pam
I was on Herceptin, Taxol and Avastin for over 6 months, then dropped the Avastin due to elevated B/P and lack of FDA Approval....both have since resolved. I continued on Herceptin and Taxol, and just recently got a 6 week repreive from the Taxol....the Avastin for me was no problem, except for the elevated B/P...I ended up going on B/P meds for it...and am, still on it, although my B/P has come done to almost normal. I never really had a problem from the Taxol, other than being bald (my hair began to return while on Taxol) nose bleeds, bleeding gums and leg cramps...it was the Decadron that did a number on me....I will be going back on Taxol or Abraxane in a week so l will see...I am excited that my eyebrows are finally coming back...I WAS ON THE COMBO A TOTAL OF 6MONTHS, AND HAD GREAT RESULTS, THEN THE TAXOL CONTINUED WITH THE HERCEPTIN FOR ANOTHER 4 MONTHS. Now just Herceptin....this combo is very promising...I am however ER - PR -, not that it makes a difference. Good Luck...the first dose takes forever....the loading of the Avastin and the Taxol.

[Pam P]

MaryAnn & Sheila
Thank you for your insights on these drugs. Interesting, MaryAnn, your experience seemed to be rougher than Sheila's on the taxol. Another craziness of all this that same drug can have such different effects on each person. I'm worried about all the side effects: bone pain, bp from the avastin, and probably more obsessed than I should be about losing my hair for a 3rd time in this assault.

I know this is vanity, but I finally look 'good' - at least people tell me I'm looking much better/more color/healthier, and that will all shift especially with the hair loss & I hate wigs & scarves. Oh well, I know I should get over it & be glad there's treatment to combat the cancer (& I am!)

BTW, I sarted on this website yrs ago, but took a long break - just couldn't handle reading about all the sad news. I just started ready some posts here in the last week and am glad to see many familiar names to me. Sheila, Steph, Lisa, Lolly, Sandy... others.... and very happy to know you're doing okay.

[Jackie07]

Welcome back, Pam. If you click on the 'search' button on the top yellow bar, you can type in "avastin" and find all the posts with that word in it.

I learned long, long time ago about "angiogenesis" when the scientist who figured out the mechanism won the Nobel Prize. (Most likely 1986, I'll check) The theory is that cancer cell grow by 'inducing' blood vessals to grow for its use - if we can stop the growth of these new vessals, we can cut the blood supply and cancer will dwindle. The problem is that our other tiny blood vessals might get affected as well.

There are several members on the board with the experience. I would click on this link often so more people get to see it.

[Jackie07]

I think Avastin blocks the VEGF receptor. Found this abstract printed in 2007. Traztuzumab = Herceptin.



HER-2-positive breast cancer: hope beyond trastuzumab.

<!--AuthorList-->Bartsch R (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Bartsch%20R%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Wenzel C (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Wenzel%20C%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Zielinski CC (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Zielinski%20CC%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Steger GG (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Steger%20GG%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).
Department of Medicine 1 and Cancer Center, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria.
Therapeutic antibodies have shown great promise as targeted agents in the treatment of patients with cancer. Trastuzumab, a humanized monoclonal antibody targeting human epidermal growth factor receptor-2 (HER-2), is of special importance in breast cancers overexpressing HER-2. Such rationally designed substances bind to cancer cells expressing the targeted antigen and, by various mechanisms, lead to tumor cell degradation. Only one-third of patients, however, initially respond to trastuzumab monotherapy and the majority of initial responders demonstrate disease progression within 1 year of treatment initiation. Therefore, alternative compounds targeting the HER-2 receptor or downstream signaling pathways are of great importance. Lapatinib is a tyrosine kinase inhibitor, blocking tryosine kinase domains of both epidermal growth factor receptor and HER-2. This substance holds promise for the treatment of cancer after trastuzumab failure, and might be active in cerebral metastases. Other strategies in trastuzumab-resistant disease include bispecific antibodies (which bind to HER-2 and Fc receptors, thereby directing immune cells towards the tumor), the combination of antibodies, or targeting tumor vessel growth by blocking vascular endothelial growth factor (VEGF) or VEGF receptors. Heat shock protein 90, a chaperone protein that controls the folding of HER-2, also represents a potential target. Multi-targeted kinase inhibitors such as sunitinib or sortenib are already established in renal cell cancer. These compounds are currently being evaluated in breast cancer and might represent interesting options both in HER-2-positive and -negative disease. In conclusion, trastuzumab remains the gold standard in HER-2-positive breast cancer therapy. However, in trastuzumab-resistant disease, new strategies and compounds are currently under evaluation.
PMID: 17402790 [PubMed - indexed for MEDLINE]

[Barbara H.]

If you don't want to lose your hair and have a very easy treatment, I would ask if there are openings in the Heceptin-MCC-Dm1 trial near you. It has really taken care of my bone mets and my markers have been in the normal range.
Best wishes,
Barbara H.

[Pam P]

Barbara H. -- Please tell me more about how you qualified for the trial. My onc. had me apply for the trial, but I didn't qualify. I just have bone mets & was told bone mets don't fit the criteria because it has to be 'measurable disease' which I guess bone mets aren't considered 'measurable'. It has to be a measurable tumor in organ, nodes, etc.

If you have more info on how to qualify with bone mets I will definitely pursue it because I really wanted to get on that trial. Please give me info. Thanks. Pam

[Barbara H.]

Hi Pam,
I don't know how I qualified, but I am in the stage I trial. Maybe bone mets qualified for that one. Stage II may have different criteria. You are correct. Bone mets are difficult to measure because the scans do not really show that they are healing the way they do with other mets. However, my pain was gone within two days. I'm sorry that you cannot get into this trial. I would try to speak with the oncologist who is in charge in your area.
Best wishes,
Barbara H.