HER2 Support Group Forums - View Single Post

Becky · 05-06-2008, 06:20 PM

Dear Brenda

I can give you some facts to ponder.

The doctor that recommended the carboplatin therapy is going on sheer "standard of care". There have been Herceptin trials that use Adriamycin+Cytoxan (AC) (4 rounds) followed by Taxol (12 weekly rounds) . These women were compared to women who took 4 rounds of AC followed by 12 weekly rounds of Taxol+ Herceptin. Another group of women took 6 rounds of Taxotere (this is a taxane and is very much like Taxol)+Carboplatin+ herceptin. The Herceptin groups continued with Herceptin alone out to one year.

The women in either Herceptin group did much, much better than the women who did not get Herceptin. Also the Taxotere,Carbo,Herceptin women did not experience heart damage or leukemia (since the Adriamycin can contribute to this). So - the Carboplatin regime has a trial behind it.

For Cytoxin, there are trials but none that contain Herceptin (that are finished with data) however the trials that have data compare Taxotere/Cytoxin to Adriamycin/Cytoxan. This was done to see if TC is more tolerable (especially to the heart) for older women. (In this case - older means over 70 yrs. Many women in this age group might not get chemo even if they need it because it may not be wise). This study said that TC is not only tolerable for this age group (heart wise) but also worked better. Adding Herceptin is assumed to be safe and I know of one woman that I counseled recently via the Amer Cancer Society's "Reach to Recovery" that is taking that combo and tolerating it very well.

One question I would ask the doctor who recommended the cytoxan combo is what data he has on stats versus the Carbo combo and why was it recommended (there is a trial going on now at Dana Farber for Stage 1 women using only Taxotere+Herceptin but adding Cytoxan is different than that). That combo, however, should work just fine and for Her2 neg women TC is a great combo versus AC and the study used women of all pathologies (and was done prior to using Herceptin in early stage).

If you have any questions at all - ask. That is the only thing I can think of to be specific about.

05-06-2008, 06:20 PM	#5
Becky Senior Member Join Date: Sep 2005 Location: Stockton, NJ Posts: 4,179	Dear Brenda I can give you some facts to ponder. The doctor that recommended the carboplatin therapy is going on sheer "standard of care". There have been Herceptin trials that use Adriamycin+Cytoxan (AC) (4 rounds) followed by Taxol (12 weekly rounds) . These women were compared to women who took 4 rounds of AC followed by 12 weekly rounds of Taxol+ Herceptin. Another group of women took 6 rounds of Taxotere (this is a taxane and is very much like Taxol)+Carboplatin+ herceptin. The Herceptin groups continued with Herceptin alone out to one year. The women in either Herceptin group did much, much better than the women who did not get Herceptin. Also the Taxotere,Carbo,Herceptin women did not experience heart damage or leukemia (since the Adriamycin can contribute to this). So - the Carboplatin regime has a trial behind it. For Cytoxin, there are trials but none that contain Herceptin (that are finished with data) however the trials that have data compare Taxotere/Cytoxin to Adriamycin/Cytoxan. This was done to see if TC is more tolerable (especially to the heart) for older women. (In this case - older means over 70 yrs. Many women in this age group might not get chemo even if they need it because it may not be wise). This study said that TC is not only tolerable for this age group (heart wise) but also worked better. Adding Herceptin is assumed to be safe and I know of one woman that I counseled recently via the Amer Cancer Society's "Reach to Recovery" that is taking that combo and tolerating it very well. One question I would ask the doctor who recommended the cytoxan combo is what data he has on stats versus the Carbo combo and why was it recommended (there is a trial going on now at Dana Farber for Stage 1 women using only Taxotere+Herceptin but adding Cytoxan is different than that). That combo, however, should work just fine and for Her2 neg women TC is a great combo versus AC and the study used women of all pathologies (and was done prior to using Herceptin in early stage). If you have any questions at all - ask. That is the only thing I can think of to be specific about. __________________ Kind regards Becky Found lump via BSE Diagnosed 8/04 at age 45 1.9cm tumor, ER+PR-, Her2 3+(rt side) 2 micromets to sentinel node Stage 2A left 3mm DCIS - low grade ER+PR+Her2 neg lumpectomies 9/7/04 4DD AC followed by 4 DD taxol Used Leukine instead of Neulasta 35 rads on right side only 4/05 started Tamoxifen Started Herceptin 4 months after last Taxol due to trial results and 2005 ASCO meeting & recommendations Oophorectomy 8/05 Started Arimidex 9/05 Finished Herceptin (16 months) 9/06 Arimidex Only Prolia every 6 months for osteopenia NED 18 years! Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"