Liver Mets Progression/Hot Shot Inhibitors
 

Hi, everyone,
The results of my scans gave good and bad news. The good is that the tumors haven't spread elsewhere from the liver, but I do have a few new spots there. Taxol and Herceptin will no longer be my protocol. My question is what worked for your liver mets when Taxol and Herceptin failed, and has anyone been treated with Hot Shot Inhibitors (my previous post listed as STA-9090)? I have been offered this trial, and I believe that this protocol may be an offshoot of HSP? Thanks for all your input.
Karen

Re: Liver Mets Progression/Hot Shot Inhibitors
 

I've taken 3 cycles (6 rounds) of abraxane and my tumors have melted away. Im doing 3 more cycles to be sure.

Re: Liver Mets Progression/Hot Shot Inhibitors
 

Hi Karen,
Sorry about the progression; remember it is just information you needed that it was time to make a change.
I am not familiar with this study, but I did hear a talk in late 2009 on HSP (Heat shock protein) inhibitors which was very exciting - and made me put them on "my list" of future options to try. STA 9090 is an HSP inhibitor, maybe you misheard the lingo.

HSP's are "chaperone" proteins which are necessary for certain signal pathways to be activated. The talk I heard discussed how HSP's are present in multiple "hallmarks" of cancer so that is exciting in that they may shut off many escapes at the same time.

I assume it is this study? What does your onc say about it - I'd be interested to hear.

http://www.cancer.gov/clinicaltrials...archid=9067965

Re: Liver Mets Progression/Hot Shot Inhibitors
 

Hi, Chrisy,
My onco wants me to join. It does sound very exciting and cutting-edge. The way it's been explained is that the drug would kill the protein that the cancer cell needs to live, thereby eradicating it. I signed up for it, but the paperwork hasn't been processed yet.
It's been used for more than just breast cancer, too.
I'm torn between conventional and "known" and this trial. Trying to guage what has worked for people, especially for liver mets. All previously-affected areas still NED.
Thanks
Karen

Re: Liver Mets Progression/Hot Shot Inhibitors
 

heat shock proteins have to do with the processing of certain "client proteins" among which are her2 and ER

Hope this helps

Re: Liver Mets Progression/Hot Shot Inhibitors
 

Hi Karen
I just read you post. I am upset. I am so sorry that Taxol is not working anymore. How many new spots did they find? The good news is for sure that there is no other location than in the liver so you can concentrate on wiping out the "stupid mets" from one place. I do not know anything about HSP but I hope it works well for you and if it doesn't I figure they will switch you back fast to other chemos, tageted therapies or surgeries like RFA if there are not too many spots. For sure you will be closely watched and you are in one of the best hospitals in the world. It is worth trying. Stay strong. Love and Hugs. Michka

Re: Liver Mets Progression/Hot Shot Inhibitors
 

OK. Here are the likely side effects: diarrhea (which you will be treated for after each infusion so you can get home), abdominal pain, fatigue, insomnia, shortness of breath, loss of appetite, increase in blood liver enzyme levels, decrease in blood phosphate levels, nausea, and changes in you ECG (decrease in heart rate by 5-10 BPM in 77% of patients).
I don't know!
I can always drop out, I guess. I'm collecting questions to ask at this point.
Michka, there were "some" (no count). They gave two measurements each 2-3 cm. They do not do cryosurgery or any type of surgical removal for these types of mets, not an option. Thanks for writing even when you are healing yourself...hope you are well!
Dawn, wonderful news for you with Abraxane...keep going!
Chrisy, I loved that you described this situation as just information needed to change my regimen. I've been repeating it!
Was was it heat shock proteins or hot shot inhibitors? I'm not positive, maybe they referred to both. Any information is greatly appreciated.
Lani, whatever you can dig up would be great. May I ask how you find all your information? Are you a health professional or just a master researcher?!
Karen

Re: Liver Mets Progression/Hot Shot Inhibitors
 

Dear Karen -

Having been a participant in some clinical trials myself, I would want to know the following. (Also, there are many more drug choices than when I was being treated.)

1. If you do this trial, what other approved drugs might be eliminated from your next possibles? Some drugs are approved for a certain line, and will these be scratched?

2. Is there a combination therapy (one that blocks several of the HER family of pathways that you could do instead)?

3. Is there something like T-DM1/pertuzamab available?

I do know they have been refining the heat shock type therapies for several years now. A friend of mine was in one of the first at my cancer center.

Re: Liver Mets Progression/Hot Shot Inhibitors
 

Hi, Steph,
How was the trip?
OK. TDM-1 is available at another hospital. Closed at my current one, with a waiting list.
I have an appointment with that hospital to check things out this coming Thursday.
STA-9090 is not chemotherapy, and I could always return to the "standard of care" (Navelbine, etc.) at any time. STA-9090 does target HER2. It is a very different therapy indeed. I've learned quite a bit about it in the last 24 hours.
Thanks. Think of other questions I might ask. I'm planning to call tomorrow.
Karen

Re: Liver Mets Progression/Hot Shot Inhibitors
 

Taxol/Herceptin worked for a good while for me, Tykerb/Xeloda worked for a year, Abraxane/Herceptin/Tykerb worked for 7 months and was still working when I began an Abraxane break at the beginning of the month. Have now added Femara to Herceptin/Tykerb instead. So plenty out there available to take up at a later date if you need to, but Steph's point about asking if the trial would preclude you from any further treatments is a good one, particularly with regard to TDM-1 (my great hope but not yet available to me). More liver mets is certainly not what you or any of us wanted to hear, but people can live a very long time even with them not totally in abeyance...and one day they may be. That is what I keep hoping. My liver is a very weird distorted looking organ these days but it keeps functioning perfectly well! All the best with your difficult decision. I'm so glad you have so many options for treatment.
Trish

Re: Liver Mets Progression/Hot Shot Inhibitors
 

Hi KDR -

This sounds very promising. What did you decide to do?

- Kim

Re: Liver Mets Progression/Hot Shot Inhibitors
 

Karen,

So sorry for the news. Hopefully the trial (or Abraxane used by Dawn) will eradicate the cancer soon.

Not sure which tool Lani is using, but the most comprehensive database is managed by the National Library of Medicine under National Health Institute and can be searched via PubMed:

http://www.ncbi.nlm.nih.gov/sites/entrez

Re: Liver Mets Progression/Hot Shot Inhibitors
 

I haven't decided yet. I have a second opinion this week. I'm leaning toward trying to get T-DM1.
Will let you know.
Karen

Re: Liver Mets Progression/Hot Shot Inhibitors
 

Thanks for all the info on HSP. I am very interested in it, too. Exclusions say more than 3 lines prior. Do you know if that is 3 lines of chemo - does it include ? I had an assay done 4 years ago that showed I would be a good candidate for a HSP so I am also putting a call into Sloan. If you can get on TDM1 I think that is a great choice - especially comparing side effects and noting how many reach NED on Tdm1.

Re: Liver Mets Progression/Hot Shot Inhibitors
 

Ok Karen - thanks for letting me know what you're up to w/this.
- Kim

Re: Liver Mets Progression/Hot Shot Inhibitors
 

Dear Karen,
Since my approach to wiping out liver mets hasn't been 100% successful, I am reluctant to chime in. But of course I want you to know I am thinking of you and wish you all the best.

I did have good luck with Abraxane as a 2nd course of treatment. I found it to be very tolerable and didn't even lose my hair. Many have had great results with Navelbine which I also found to be quite tolerable. I believe that by the time I had Navelbine, the scar tissue etc in my liver from cryosurgery impacted the ability of chemo to get to the liver.

I am pleased that the big guns (lani, chrisy, Step) are helping you with the heat shock decision. Steph rasises great questions and really working closely with your Onc to get the facts will serve you well. That way, your onc will be aware of your concerns and will be part of a long term strategy for you.

Honestly.....If you could swing a TDM-1 opportunity I would choose that route. It just seems as if there have been so many good results posted on the site.

Here is to an upcoming dance with NED....Lori