HER2 Support Group Forums - View Single Post

chrisy · 04-20-2007, 05:53 PM

Dear Rupali,
Yes, lots of people are asking this same question - MicheleU is also Stage III and is in the process of trying to get it (and deal with the insurance issues). In the US, the FDA approval is for Stage IV in combination with Xeloda. So any other use, such as in your case without metastatic disease, would be considered "off label" and therefore a tougher decision and more difficult. But possible as Michele has found out.

Because Tykerb also targets HER2, there is still a concern with cardiac toxicity - maybe not as much but I don't know that there is a lot of data in this regard. I know that part of the qualification for the trial I am going into (Tykerb/Avastin) is, you guessed it, LVEF in normal range. So having an LVEF of 45-50% may put you at risk or preclude you from getting this drug. Might be better to get your heart back up to full strength first.

Also, remember you have had a lot of herceptin - seems like double the normal course of treatment.

It's a tough decision in your situation, I know. My advice would be to get your heart function back up before thinking about hitting it again with the Tykerb.

04-20-2007, 05:53 PM	#2
chrisy Senior Member Join Date: Sep 2005 Location: Central Coast, CA Posts: 3,207	Dear Rupali, Yes, lots of people are asking this same question - MicheleU is also Stage III and is in the process of trying to get it (and deal with the insurance issues). In the US, the FDA approval is for Stage IV in combination with Xeloda. So any other use, such as in your case without metastatic disease, would be considered "off label" and therefore a tougher decision and more difficult. But possible as Michele has found out. Because Tykerb also targets HER2, there is still a concern with cardiac toxicity - maybe not as much but I don't know that there is a lot of data in this regard. I know that part of the qualification for the trial I am going into (Tykerb/Avastin) is, you guessed it, LVEF in normal range. So having an LVEF of 45-50% may put you at risk or preclude you from getting this drug. Might be better to get your heart back up to full strength first. Also, remember you have had a lot of herceptin - seems like double the normal course of treatment. It's a tough decision in your situation, I know. My advice would be to get your heart function back up before thinking about hitting it again with the Tykerb. __________________ Chris in Scotts Valley June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?" 9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++ 10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response! 04/05 - 4/07 Herception every 3 wks, Continue NED 04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial 06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin 01/08 Progression in liver 02/08 Begin (TDM1) trial 08/08 NED! It's Working! Continue on TDM1 02/09 Continue NED 02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED 12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver 07/11 - 11/11 Herceptin/Xeloda -not working:( 12/11 Begin MM302 Phase I trial - bust:( 03/12 3rd times the charm? AKT trial 5/12 Scan shows reduction! 7/12 More reduction!!!! 8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!) 9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3 11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc 11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go. 2/13 Gemzar/Carbo/Herceptin - no go. 3/13 TACE procedure