whole brain radiation
Hi, I have a friend diagnosed 2.5 years ago, ER-PR-, Her2 positive. She is in her 40's. She is Stage IV with lung, liver, bone, brain mets. She was originally diagnosed Stage III, but went Stage IV shortly after stopping Herceptin. She is on chemo, plus Herceptin and I am not sure what else. She already has had whole brain radiation once. She has permanent hair loss. Her last CT showed progression and the docs are recommending a 2nd whole brain radiation. What should she do? Should she seek a 2nd opinion at this point from an MD Anderson or a Mayo. She is currently being treated by a top teaching hospital, but I know she is desparate for next steps and a 2nd whole brain radiation sounds rather dire to me.
Any help with this would be appreciated. I am just devastated by this news. I hate cancer. Her suffering has got to be unbearable and she has 2 young children. I have prayed so hard for her, lit candles at churches everywhere...I will continue to pray that is all I can do. |
Re: whole brain radiation
Oh JillaryJill, I just don't have a good answer for you.
Perhaps the IT Herceptin? Hopefully we will hear from someone with experience with brain mets soon. |
Re: whole brain radiation
I am in the same position as your friend. 42 with lung, brain, bone and liver mets. I just finished WBR and have had gamma tx twice. My oncs do not recommend WBR twice. I am sorry. I feel horrible after this round. I feel defeated and ready to throw in the towel today. I have lasted 1.5 yrs. Maybe IT Herceptin.
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Re: whole brain radiation
Neratinib for HER2-Positive Brain Metastases
A Phase II Trial of HKI-272 (Neratinib) for Patients With Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Breast Cancer and Brain Metastases (11-344) Summary Brain metastases are difficult to treat because many drugs are unable to cross the blood-brain barrier, which means they cannot enter the brain from the bloodstream. The experimental drug Neratinib (HKI-272) is a tyrosine kinase inhibitor. It works by blocking the HER2 and EGFR receptors, both of which are involved in cancer cell growth. Neratinib is a much smaller molecule than Herceptin® (the drug widely used to treat HER2+ tumors), and it is able to cross the blood-brain barrier. The goal of this trial is to determine how well neratinib works in treating breast cancer that has spread to the brain, as well as the effect that it has on cognitive functioning. This is a Phase II trial |
Re: whole brain radiation
HKI-272 for HER2-Positive Breast Cancer and Brain Metastases
Basic Trial Information PhaseTypeStatusAgeSponsorProtocol IDsPhase IIBiomarker/Laboratory analysis, TreatmentActive18 and overOther11-344 TBCRC 022, NCT01494662 Trial Description Summary The purpose of this research study is to determine how well neratinib works in treating breast cancer that has spread to the brain. Neratinib is a recently discovered oral drug that may stop breast cancer cells from growing abnormally by inhibiting (or blocking) members of a family of proteins that include Human Epidermal Growth Factor Receptor 2 (HER2). In this research study, the investigators are looking to see how well neratinib works to decrease the size of or stabilize breast cancer that has spread to the brain. The investigators are also looking at how previous treatments have affected your thinking (or cognition) and how much neratinib reaches the central nervous system. Further Study Information Subjects will receive neratinib and a drug-dosing calendar for each treatment cycle. This drug is given orally on a daily basis, continuously. Each treatment cycle will last for 4 weeks during which time the subject will be taking neratinib every day.
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Re: whole brain radiation
After the final dose of the study drug:
You will have a follow-up visit one month after coming off study treatment. During that visit, you will have a physical examination, functional assessment, assessment of any toxicities and current medications, and a neurological examination. If you continue to have ongoing toxicity related to your study treatment, we will continue to follow you until this toxicity resolves. In addition, we will collect about 5-6 tablespoons of blood for research and to measure if a marker for your particular breast cancer exists. We would like to keep track of your medical condition for up to two years after you stop the study treatment. If you are not seen in follow-up at your participating center (where you enrolled on the study), we would like to follow you by calling you on the telephone or by sending you a letter once a year to see how you are doing. We may also contact your doctor once every 6 months to see how you are doing. Keeping in touch with you and checking your condition every year helps us look at the long-term effects of the research study. If you do not wish to be contacted after you stop the study treatment, you must notify the research study staff of your withdrawal of consent for follow-up Eligibility Criteria Inclusion Criteria:
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Re: whole brain radiation
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Re: whole brain radiation
How about injecting herceptin directly to the brain? Paul's wife and some other members seem to have had a good response to this type of treatment. I think UCLA is the only place that does it in California.
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Re: whole brain radiation
My radiation oncologist never mentioned WBR as being an option more than once. I was under the impression the risk of damage to the brain is too high. Is cyberknife or gamma knife an option that has been mentioned? That is what my radiation oncologist plans to do if/when the brain tumors recur. I think that a second opinion would be a good idea. I actually think a second opinion is always a good idea. I am so sorry that your friend is facing such a tough situation. I will absolutely pray for her and her family. Please keep us updated!
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Re: whole brain radiation
Thank you Lizabeth for all the info. I forwarded this to my friend. The trial sounds like something she would qualify and one of the locations is Michigan which would be doable for her.
Sdgirl...I am so sorry you are suffering also. I hope that this information sharing on this board can help you with next steps also. KsGal...love the bluebird. We had a female and male nest in our yard last summer. I thought it was a sign of good luck. They were so fun to watch. |
Re: whole brain radiation
Talk to Amal Melhem-Bertrandt at MD Anderson in the Breast Cancer center. She is the person treating my wife Nina. Nina is 4 years to the good since Brain lesion was discovered and nearly two years to the good since spinal involvement was discovered. I would ask for Topotecan and IT Pertuzumab (40 mg weekly for four weeks, then 80-100 mg weekly after that). USC in LA was supposed to run a clinical trial at that dose, but there is some hold up. If not, use Herceptin instead of Pertuzumab. Results have been really good so far. Ask for Compassionate Care use to get around some government regulatory issues that could delay treatment. Private E-mail back if you want more info.
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