['lizbeth]

Evlin,

I understand that you are reluctant about clinical trials but it is likely to be the best option at this point. All cancer treatment drugs have toxicities, some worse than others. The ones in studies are no more toxic then Taxol, or TDM1 or Adriamycin that are approved and being used currently.

On the other hand - Targeted treatments such as Herceptin and Perjeta can be effective without the harshest of side effects.

Did you daughter take Herceptin and Perjeta at the same time? Targeted therapies are more likely to be effective when combined.

Had the tumors been genetically tested for other pathways? Perhaps targets outside of the Her2 receptor could be effective as well.

If the node at the clavicle could be removed and sent to Rational Therapeutics for functional profiling they could test with cell death end points to see which treatments would be most effective. I'd talk at least contact them and consider it as an option since your daughter has difficulty tolerating chemo treatments.

I'm sorry that you are back in the search for the next option. How did the PET scan go? And what are the doctors advising? Any word yet?