What worked for you?

[adrien]

Hi,
I have several liver mets, the largest over 4cm, and a scattering of lung mets. I'd like to know a cross section of treatments that worked for those of you with similar issues. It's the liver I'm most interested in.

[Jackie07]

Adrien,

I 'searched' past postings and found that Lori R and CourtneyL both are currently undergoing treatment for liver mets. I hope they will see your thread and reply soon.

[adrien]

Thanks Jackie,
It's nice to know people are looking out for others.

[Rich66]

Go to this page (http://her2support.org/vbulletin/showthread.php?t=30283&page=7&highlight=StephN) and you can see Andrea and Steph N's treatment profiles in their posts. MamaCZ had complete remission on Navelbine/Herceptin. All had liver mets. Note that they are ER/PR-. Some significant thought out there that Chemo is not as helpful to ER+. But..there is some info and case studies regarding combining chemo and endocrine, i.e. "chemoendocrine" therapy. Rapamycin (http://her2support.org/vbulletin/showthread.php?p=214219#post214219) may be helpful in reversing resistance to some chemos. And the delivery of what you have already had may be worth investigating. Did you have Decadron (glucocorticoid) with your Taxotere? May have interfered (http://her2support.org/vbulletin/showthread.php?p=214831#post214831). Some have revisited "failed" chemos in a lower-dose/metronomic (http://her2support.org/vbulletin/showthread.php?t=24729&highlight=metronomic) fashion without breaks and had benefit. Cyclophosphamide is a favorite tool of metronomic guru, Dr. Kerbel. Capecitabine and Cyclophosphamide have been combined. Faslodex has been shown to synergize with chemo (http://her2support.org/vbulletin/showthread.php?t=39371&highlight=Fulvestrant). There is thought that her2 therapies push the cancer to rely more heavily on estrogen and vice versa, suggesting blocking both pathways (http://her2support.org/vbulletin/showthread.php?t=39169) as best. There are strategies to sensitize or reverse resistance to ER therapies (http://her2support.org/vbulletin/showthread.php?t=40481&highlight=endocrine). Since Her2+ is more often ER-, it can be hard to good examples here. There are numerous liver directed thrapies. RFA, SirSpheresMy mom is in the exact same boat, mets-wise (though her2 borderline) as you and Xeloda gave her the best run so far.

[Chelee]

Rich, Very impressive! I was going to give her a few names and you beat me to it. You covered alot of ground & then some. I'm glad you stick around here...your posts are always so informative. Great job. :)

Chelee

[StephN]

Hello Adrien -
sorry your liver mets are on the march again. I hit my mets hard with a 3-pronged approach: Taxol, Navelbine and Herceptin all at the same time. They never came back, but I am the exception.

You need to fight mets in more than one area, so I do think you need a combo of drugs that will close pathways, as well as kill the cancer cells.

I learned at San Antonio about the difficulty with treating "hetergenous" BC, which uses more than one pathway or is able to switch them on and off. Makes it all more complicated. (Sort of made my head swim!)

I hope the Herceptin will help, but you need something else that is synergistic with H. You already had Tykerb, but with what?

[Carolyns]

Hi Adrien,

I have had liver mets for going on 4 years now. I am ER positive and Her2 positive. The liver mets have responded to (in this order) - Gemzar w/ Herceptin, Herceptin w/ Tykerb, Abraxane w/ Herceptin, Xeloda w/ Tykerb. I am presently on TDM1 with Pertuzumab since Sept. 2009 via a trial that is closed now).

I have mets in liver, skin and lymph nodes.

Best wishes to you.

Carolyn

[Ellie F]

Carolyns- how are you on T-DM1? Do you also get pertuzumab as well?
Ellie

[Carolyns]

Hi Adrien, I forgot to add that I was also on Navelbine.

Ellie F. - TDM1 has gotten much easier for me and we added Pertuzumab. Scans have been good and the liver has improved. I still work full time (home based) and take care of my 11 year old son as a single parent.

[Lori R]

Hi Adrian,
Isn't this site amazing.....Jackie has a great memory to recall that Lori R was dealing with liver mets. Quite impressive the folks on this board.

I used cryosurgery to whack down a liver met in May of 2009. We decided on a one...two punch and followed the cryosurgery with Abraxane to knock down any remaining cells. I just finished the Abraxane treatment in early November. I passed a scan in August with flying colors and will have a follow up scan in a couple of weeks. (to say I am having scanxiety is an understatement)

I am soooo hoping that I'll be able to return with good news.

I wrote a lengthy overview of the cryosurgery procedure and how relatively simple the procedure and recovery was. (at least for me).

Please let me know if you have any questions. I work full time, so I can't spend too much time on the site at work. I'll try to log in tonight when I get home.

Lori

[DanaRT]

Rich, You are a wealth of information and very generous to share. This is the first I have read that Decadron may interfere with Taxotere...well, ...darn.

Adrien, I will be watching this thread to see how you're doing and read what you've discovered.

Love,
Dana

[Kathy T]

Carolyn
You and I are on the same trial--when did you add Pertuzamab--I have staging this week so may be adding next time. Has it been an easy drug so far?
Kathy T

[CourtneyL]

Hi Adrien - I am sorry to hear that you are dealing with liver and lung mets. What a crappy way to start the new year. Jackie is right, I have successfully battled both. When I was first diagnosed in April 2008, I had too many liver mets for them to even count and a smattering of spots on my lungs. We did an aggressive treatment of Herceptin, Cytoxan and Taxotere - every two weeks for 7 rounds. Then we dropped the Cytoxan and did one more with Taxotere. This combo got me almost to NED when it spread to my brain. So then I added Tykerb and eventually Xeloda to the Herceptin. That kept things in check for a long time - until this past October when I had some slight progression in my lung nodules. Now I am on Herceptin and Gemzar and my markers are dropping. Haven't re-scanned yet so I don't know for sure that it is all gone but I feel great and am confident things are going well on the inside. Gemzar is the easiest chemo I've ever been on.

Praying you find your magic bullet! Let me know if there is anything I can do!

[waterdreamer]

Rich, I am on Taxotere and Herceptin, and I am given Decadron prior to infusions. Where can I find information that indicates that Decadron may interfere with the effectiveness of Taxotere?
Thank you
Fern

[Rich66]

Glucocorticoids (http://her2support.org/vbulletin/showthread.php?p=214831%23post214831)

[adrien]

Wow,
haven't logged on for a while. (Went a bit (lot) down). Will keep logged in more often now.
Will take this battery of suggestions to my 2nd and 3rd opinions coming up soon. Have now found tumour in right breast. Seems strange since I've had positive right lymph node for 3 years and not a sign in mammos or MRI until now.
Thank you everyone. Feel well supported.