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Old 05-09-2008, 03:25 PM   #1
Pam P
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taxol & avastin - starting next week

I will be starting weekly taxol & avastin every other week. I'd like to hear from others who have experience on this. I have bone mets and also get aredia 1 time a month.

I am just discontining xeloda. I've been on xeloda over 3 1/2 yrs, 1st with herceptin, then with tykerb. This worked so well for me for a long time. The hand/foot issues were hard at times, but all in all I didn't really feel like I was on chemo.

I'm really dreading having to go back to a harder chemo regimen, the weekly IV sessions, losing my hair, etc. I work full time & am worried about being able to feel good enough to maintain reasonable work schedule too.

I have bone mets. My CT/PET & CT scans last month were stable, but my ca2729 has risen steadily for last several months. Latest was 603, up from about 200 last fall. So my dr. thinks I need to switch meds.

I appreciate knowing what others think & your experience with taxol & avastin. I had 4 tx with taxol in my initial chemo and recall the bone/joint pain & neuropathy for me was really painful.

Thanks. Pam

6/2001 - dx IBC, ER+, HEr2+
mastecomy
chemo: 4 ac/cytoxin & 4 taxol, followed by rads to chest
2/2002 - tamoxifen
9/2002 - bone mets - femara & aredia
1/2003 - taxotere & herceptin & aredia
6/2003 - faslodex & aredia
1/2004 - navelbine & herceptin & aredia
1/2005 - herceptin & aredia
7/2005 - xeloda & herceptin & aredia
3/2007 - xeloda & tykerb & aredia
5/2008 - starting taxol, avastin & aredia
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Old 05-09-2008, 03:43 PM   #2
Mary Anne in TX
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Pam, I haven't taken Avastin, but I've riden the Taxol train. It is tough, but you make that trip with your head high and your heart determimed to take it one day, one treatment at a time. Those crumby mets just better get out of the way. The heavy duty stuff is on it's way. Really, Pam, I'm praying for you and believing that your journey will be smooth and filled with ever decreasing tumor marker scores. The very best to you, ma
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MA in TX.
Grateful for each and every day....

Diag. 12/05 at age 60
Stage II, Grade 3, 4.5 cm primary tumor
ER/PR- Her2 +3 strongly positive
Her2 by FISH 7.7 amplified
vascular invasion
Ki67 20% borderline
Jan - March '06 Taxotere/Adriamycin X 3 to try to shrink tumor - it grew
April '06 Rt Modified Radical Mas, 7 of 9 nodes positive
April - Aug. '06 Herceptin/Taxol/Carboplatin X 8 (dose dense)
Sept - Dec. '06 Navelbine/Herceptin x 8 (dose dense)
Radiation & Herceptin Jan. 22 - March 1, 2007
Finished Herceptin Dec. 10 '08! One extra year.
Port removed August, 2012.
8 1/2 years since diagnosis! 5 1/2 Years NED!
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Old 05-09-2008, 03:53 PM   #3
Sheila
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Pam
I was on Herceptin, Taxol and Avastin for over 6 months, then dropped the Avastin due to elevated B/P and lack of FDA Approval....both have since resolved. I continued on Herceptin and Taxol, and just recently got a 6 week repreive from the Taxol....the Avastin for me was no problem, except for the elevated B/P...I ended up going on B/P meds for it...and am, still on it, although my B/P has come done to almost normal. I never really had a problem from the Taxol, other than being bald (my hair began to return while on Taxol) nose bleeds, bleeding gums and leg cramps...it was the Decadron that did a number on me....I will be going back on Taxol or Abraxane in a week so l will see...I am excited that my eyebrows are finally coming back...I WAS ON THE COMBO A TOTAL OF 6MONTHS, AND HAD GREAT RESULTS, THEN THE TAXOL CONTINUED WITH THE HERCEPTIN FOR ANOTHER 4 MONTHS. Now just Herceptin....this combo is very promising...I am however ER - PR -, not that it makes a difference. Good Luck...the first dose takes forever....the loading of the Avastin and the Taxol.
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Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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Old 05-10-2008, 04:38 AM   #4
Pam P
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MaryAnn & Sheila
Thank you for your insights on these drugs. Interesting, MaryAnn, your experience seemed to be rougher than Sheila's on the taxol. Another craziness of all this that same drug can have such different effects on each person. I'm worried about all the side effects: bone pain, bp from the avastin, and probably more obsessed than I should be about losing my hair for a 3rd time in this assault.

I know this is vanity, but I finally look 'good' - at least people tell me I'm looking much better/more color/healthier, and that will all shift especially with the hair loss & I hate wigs & scarves. Oh well, I know I should get over it & be glad there's treatment to combat the cancer (& I am!)

BTW, I sarted on this website yrs ago, but took a long break - just couldn't handle reading about all the sad news. I just started ready some posts here in the last week and am glad to see many familiar names to me. Sheila, Steph, Lisa, Lolly, Sandy... others.... and very happy to know you're doing okay.
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Old 05-10-2008, 11:57 AM   #5
Jackie07
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Welcome back, Pam. If you click on the 'search' button on the top yellow bar, you can type in "avastin" and find all the posts with that word in it.

I learned long, long time ago about "angiogenesis" when the scientist who figured out the mechanism won the Nobel Prize. (Most likely 1986, I'll check) The theory is that cancer cell grow by 'inducing' blood vessals to grow for its use - if we can stop the growth of these new vessals, we can cut the blood supply and cancer will dwindle. The problem is that our other tiny blood vessals might get affected as well.

There are several members on the board with the experience. I would click on this link often so more people get to see it.
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http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016
7-23-2018 9 mm groundglass nodule within the right lower lobe with indolent behavior. Due to possible adenocarcinoma, Recommend annual surveilence.
7-10-2019 CT to check lung nodule.
1-10-2020 8mm stable nodule on R Lung, two 6mm new ones on L Lung, a possible lymph node involvement in inter fissule.
"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe
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Old 05-10-2008, 12:12 PM   #6
Jackie07
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I think Avastin blocks the VEGF receptor. Found this abstract printed in 2007. Traztuzumab = Herceptin.



HER-2-positive breast cancer: hope beyond trastuzumab.

<!--AuthorList-->Bartsch R, Wenzel C, Zielinski CC, Steger GG.
Department of Medicine 1 and Cancer Center, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria.
Therapeutic antibodies have shown great promise as targeted agents in the treatment of patients with cancer. Trastuzumab, a humanized monoclonal antibody targeting human epidermal growth factor receptor-2 (HER-2), is of special importance in breast cancers overexpressing HER-2. Such rationally designed substances bind to cancer cells expressing the targeted antigen and, by various mechanisms, lead to tumor cell degradation. Only one-third of patients, however, initially respond to trastuzumab monotherapy and the majority of initial responders demonstrate disease progression within 1 year of treatment initiation. Therefore, alternative compounds targeting the HER-2 receptor or downstream signaling pathways are of great importance. Lapatinib is a tyrosine kinase inhibitor, blocking tryosine kinase domains of both epidermal growth factor receptor and HER-2. This substance holds promise for the treatment of cancer after trastuzumab failure, and might be active in cerebral metastases. Other strategies in trastuzumab-resistant disease include bispecific antibodies (which bind to HER-2 and Fc receptors, thereby directing immune cells towards the tumor), the combination of antibodies, or targeting tumor vessel growth by blocking vascular endothelial growth factor (VEGF) or VEGF receptors. Heat shock protein 90, a chaperone protein that controls the folding of HER-2, also represents a potential target. Multi-targeted kinase inhibitors such as sunitinib or sortenib are already established in renal cell cancer. These compounds are currently being evaluated in breast cancer and might represent interesting options both in HER-2-positive and -negative disease. In conclusion, trastuzumab remains the gold standard in HER-2-positive breast cancer therapy. However, in trastuzumab-resistant disease, new strategies and compounds are currently under evaluation.
PMID: 17402790 [PubMed - indexed for MEDLINE]
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Jackie07
http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016
7-23-2018 9 mm groundglass nodule within the right lower lobe with indolent behavior. Due to possible adenocarcinoma, Recommend annual surveilence.
7-10-2019 CT to check lung nodule.
1-10-2020 8mm stable nodule on R Lung, two 6mm new ones on L Lung, a possible lymph node involvement in inter fissule.
"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe
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Old 05-10-2008, 12:46 PM   #7
Barbara H.
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trial

If you don't want to lose your hair and have a very easy treatment, I would ask if there are openings in the Heceptin-MCC-Dm1 trial near you. It has really taken care of my bone mets and my markers have been in the normal range.
Best wishes,
Barbara H.

Last edited by Barbara H.; 05-10-2008 at 12:48 PM..
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Old 05-10-2008, 07:19 PM   #8
Pam P
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Barbara H. -- Please tell me more about how you qualified for the trial. My onc. had me apply for the trial, but I didn't qualify. I just have bone mets & was told bone mets don't fit the criteria because it has to be 'measurable disease' which I guess bone mets aren't considered 'measurable'. It has to be a measurable tumor in organ, nodes, etc.

If you have more info on how to qualify with bone mets I will definitely pursue it because I really wanted to get on that trial. Please give me info. Thanks. Pam
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Old 05-11-2008, 07:43 AM   #9
Barbara H.
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Hi Pam,
I don't know how I qualified, but I am in the stage I trial. Maybe bone mets qualified for that one. Stage II may have different criteria. You are correct. Bone mets are difficult to measure because the scans do not really show that they are healing the way they do with other mets. However, my pain was gone within two days. I'm sorry that you cannot get into this trial. I would try to speak with the oncologist who is in charge in your area.
Best wishes,
Barbara H.
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