New Info on Tykerb

[Sheila]

I read this today and felt it was interesting....I went for my Herceptin treatment yesterday and asked my onc. about Tykerb...she is not ready to "jump on the bandwagon yet." She feels that the risks of Tykerb are higher than Herceptin, and that many will show after women have been on it, as did Herceptin. I did however get the good news that once again I get a drug Holiday from the Xeloda....mainly because the node is "stable" and my feet look bad. Last time it didn't last a month so I will see.....
Sheila


Tykerb Helps Late-Stage Breast Cancer


Tykerb/Xeloda Combo Slows Cancer Progression, but Doesn't Extend Life <TABLE cellSpacing=0 cellPadding=0 width="90%" border=0><TBODY><TR><TD vAlign=top width="45%">By Daniel DeNoon

WebMD Medical News


</TD><TD vAlign=top width="55%">Reviewed By Louise Chang, MD



on Wednesday, December 27, 2006


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Dec. 27, 2006 -- A combination of breast cancerbreast cancer drugs -- Tykerb and Xeloda -- slows metastatic breast cancercancer after Herceptin finally fails.

However, the combination treatment did not extend patients' lives in an international clinical trial.

In the trial, Charles E. Geyer, MD, of Allegheny General Hospital, Pittsburgh, and colleagues studied 324 women with metastatic breast cancer, meaning their cancer had spread to other organs.

Nearly all had been treated with Herceptin for a median of 42-44 weeks.

Half the women then got Xeloda chemotherapy; the other half got the Tykerb/Xeloda combination.

Those who got the combination therapy had more than a 50% delay in disease progression. Their cancer once again began to spread after a median 8.4 months, vs. 4.4 months for those who got Xeloda alone.

Adding Tykerb to the Xeloda did not worsen the side effects of the cancer chemotherapy.

However, it also did not increase the amount of time the women lived.

Tykerb is one of the new targeted treatments for cancer -- a promising weapon in the arsenal against the disease. Tykerb is an experimental drug not yet approved for marketing.

About 20% of breast cancer patients have HER2-positive cancers -- tumors that have too much of a type of protein called HER2 protein. Herceptin, a man-made antibody, targets these cancers.

But metastatic breast cancer eventually becomes resistant to Herceptin. Moreover, metastatic HER2-positive breast cancer often spreads to the brain, where Herceptin and other chemotherapies can't reach.

Researchers have searched for new drugs that target HER2 and that can enter the central nervous system.

Tykerb is such a drug.

The findings from this trial of Tykerb with Xeloda appear in the Dec. 28 issue of The New England Journal of Medicine.

In an editorial accompanying the report, Vermont Cancer Center researcher Hyman B. Muss, MD, notes that targeted treatments such as Tykerb are major advances -- and major expenses.

Muss suggests that when the new drugs offer a cure, they are well worth the expense.

But he questions whether they are worth the cost if they only delay disease progression for a few months -- as was the case in this study.

"Currently, the greatest potential for these agents lies in their use as adjuvant therapy, before metastatic disease is evident, and when their addition to chemotherapeutic agents may improve the chance for a cure," Muss says.

Clinical trials -- some now underway, some still in the planning stages -- will test whether Tykerb and other new cancer drugs can be used earlier in the course of disease.

SOURCES: Geyer, C.E. The New England Journal of Medicine, Dec. 28, 2006; vol 355: pp 2733-2743.

[Becky]

Good news on your node stability - and just when the flip flops will be rappant in the stores. I will still look to see if there are some great ones around anyway.


I miss you.

Love,

[Jean]

Sheila,
Happy for you regarding your stable node! Way to go.
Interesting article, am I correct in understanding that Dr. Muss
believes that Tykerb should be given as an adjuvent treatment
to early stagers?

Isn't there a trial with the Tykerb for early stage disease
with herceptin ?

Wishing you continued good news.

Hugs,
Jean

[rinaina]

Great news Sheila on the node being stablized. My doctor told me that they are finding heart side effects with Tykerb and said we will know more in time. Thanks for the post.

[Sheila]

My Onc. is also worried about the heart issues with Tykerb...said time will tell. It looks like it is most promising in the adjuvant or early setting from what I have read....much like Herceptin has turned out. I will be watching to see if things change on the results from the trials.

[Sandy H]

I wonder what kinds of heart side effects they are having?? I would be interested in knowing seems I am on Tykerb. Where are they getting this info? I will ask my oncologist I am seeing here in Destin, Florida and e-mail my back home oncologist and see if he knows. I will see if I can research this. Any help with this would be appreciated. hugs, Sandy

[Sheila]

Sandy

My onc. did not say, she just said there were more side effects with Tykerb, esp. heart than with Herceptin...this may be based on past chemo tx before Tykerb, I don't know....she was not ready to prescribe it unless it was a last ditch effort so to speak...she said more time will tell the safety of the drug. The good news is, you are proving it works and you have minimal side effects....everyone reacts differently, so happy it is the magic drug for you....
by the way, anymore new shoe finds in Destin???? They have great little shops in Seaside on the beach, one of my favorite places to go!

[Sandy H]

Thanks Sheila: No more shoes yet but still have plenty of time. I did purchase a new robe, slippers, socks, and two fleece vests! How is that for window shopping? Also just found out that I don't have to have 6 weeks mugas! They will be done every 3 months and I asked if it was because I have not had any problems with my heart. I was told he believed that was just a change in protocal!! Sounds like its not too big a problem or they would not change the mugas to 3 months while on Tykerb. Great news for me as I didn't like having muga that often. Always something new around the corner. hugs, Sandy

[Sherryg683]

I guess if you ask 10 different Oncologists you would get 10 different answers. I asked my Oncologist about Tykerbs side effect and he said there were very few and he didn't see the heart problems that was associated with Herceptin. He said his patient that were on it were responding quite well and these were women who hadn't responded to anything. He did say he saw an increase in billiruben (sp?) in the blood tests though, but the patients didn't have any physical effects from this. I guess as with any new drug, it will take awhile for the side effects to really present themselves. Like the Herceptin headaches that are not suppose to be caused by herceptin......sherryg683

[chrisy]

Sherry - It's so true about the different opinions - although sometimes I think its more like ask 10 oncologists, get 15 opinions! I think this is even more likely to be the case when the question at hand is one on which the data is nonexistent, inconclusive, or early as is the case with Tykerb. There are still so many questions no wonder there are different answers! I think time will tell on this. You'll be one of the pioneers!

Sandy- sounds like you're shopping on the wrong side of the windows! That is such a fun part of being on vacation for me - somehow I get all relaxed and start losing all inhibition! Hope you buy some suitcases for all your new finds!

Sheila - maybe you should buy stock in one of those flip flop companies and influence them to somehow figure out how to make them warmer in winter. We're having record cold spell here in California, so I can't even wear them here! Glad to hear you're stable again (the node that is) and I hope this time it stays that way.

Love you all
Chris

[IRENE FROM TAMPA]

I also ready about Tykerb not really prolonging one's life -

I just met with my onc. yesterday to get the results from my latest scans.

He is considering me also stable .

Sheila when you onc say's stable. Is your tumor still there but has not changed in size? What size is your tumor? I had two to start with but they only see one now on my PET. I don't really like the Imaging center I had to change to due to change in insurance. The radiologist never reports size only and increase in the uptake.

I am going to change facilities for my next scans. I know that it is not good to keep changing, but I am not please with this center.

My bilirubin has also gone up since on this regimen and I thought I had also read where the Tykerb could be the cause of this. My liver enzymes are good so my onc. is going to keep and eye on them...

Sandy - yes, the protocol changed and I had to sign a form yesterday saying that the scans do not have to be done every 6 weeks anymore so my next one's will be in 3 months. I will have blood in 3 weeks and then again before I see the doctor next time. He wants to monitor my feet, since they are taking a beating from the Xeloda.

I was sorry to hear of possible side effects to the heart though. My latest heart scan shows my percentage at 58 % which is not bad and consistant to the past.

So...although I am not happy that my tumor is not compelety gone - it is still about the same size which is about 3-4 cm since I began the trial 6 months ago, but at the least it's not anywhere else that they could see and holding stable. I have to be grateful for that.

[Sandy H]

Irene, its to good to hear from you. I am thrilled we don't need scans every 6 weeks!!!! I am also thrilled to hear you are stable!!! That is so wonderful. I take extra care of my feet with Arbonne foot cream and so far have not had any problems I pour the cream on everytime I think about it some times every 15 minutes, as I figure the more the better. I have to disagree when they are saying this drug does not prolong survivorial. If we are stable using it then we are surviving longer is how I see it. I am expecting my oncologist to stop the xeloda as soon as it is released next month as he told me he didn't like it because of side effects. For me its been a miracle drug, it has given me back my life for 5 months now and I feel good. I am so happy not to have to go to oncology every week and most of all to be here in Destin for two months. We are going to go to Bilioxi, Miss next week for a couple of days. May go into New Orleans as well. Still having a great time in Destin and not missing the snow and cold. Thanks Irene for updating us as I was thinking about you. hugs, Sandy

[Sheila]

Irene

Yes my tuor or enlarged node is still there, it has not changed in size for 3 months, it is about the size of a peas...hard to measure but easy to palpate...it was the size of a lima bean when it first appeared. The first round of Xeloda, it totally disappeared, but readed its head after a month off Xeloda, so I went back on the Xeloda, it shrunk but did not completely go away...so now after 6 cycles, I am off again and although it is stable now, I have to wait and see what it does. A friend of mine has the same issues with the neck nodes. WXeloda quit working for her, she went on Abraxane weekly....that only lasted 2 months and the Abraxane quit working. Next she will be on Navelbine. These nodes in the neck are very stubborn, as Lolly knows. I am enjoying the break from Xeloda and hoping that my feet will heal...they are so red and burning all the time....at least my hands are healing.

[Sherryg683]

Sandy, I have to agree with you. If it prolongs or reduces the time the cancer grows, doesn't that automatically give you more survival time??? Maybe they are figuring it on an average of a bunch of people where some didn't respond to tykerb and others did. I say, if it keeps your tumor from growing for 6 months..that's six months longer you have. And didn't they stop the trials early because it was showing success? They apparently only have short term data about it and not how it will act long term right?? sherryg683