time for new treatment plan-is xeloda still effective?

Shell · 03-17-2006, 05:23 AM

With a reoccurrence to lungs, I have been on xeloda since May. Orignial treatment for stage IIIC was neoadjuvant TEC(taxotere)/x4, then lumpec + SNB (negative), then TEC/x2, followed by radiation and 3 months of navelbine/herceptin preventatively. Reoccurrence in < year in lymph nodes. Had complete axilla dissection, then 3 months of taxotere/herceptin. Reoccurrence towards end of treatment, with nodes in lungs.

I am paritcipating in the xeloda with or without lapatinib clinical trial, in which I drew the arm only getting xeloda. Initial scans in xeloda treatment plan were great - last 2, though, have shown minimal, but progression, of some measured areas. I need to evaluate whether to stay on xeloda, or concede it is not working, or perhaps add another chemo to the mix. Any thoughts on options?

Shell

Lolly · 03-17-2006, 08:14 AM

Shell, my first thought would be to add Herceptin back into the mix. Of course, you'd have to drop out of the trial, but I assume you're going to be doing that anyway with progression and needing to add or switch chemo's.

I'm on a combination of Herceptin/Navelbine/Xeloda for stubborn mets to the lymph system, and since adding Xeloda last month we've seen measurable improvement as opposed to stable disease. This is a departure for me, as for each of three recurrences to these same nodes since 2001, we've used just Navelbine with Herceptin with good results. My onc felt that since I had good responses with Navelbine, and periods of either remission or stable disease in between while on Herceptin alone, that Navelbine was still a good option for me, and he has been right on.

Although you had Navelbine previously, I'm assuming from your post that you had recurrence some time after finishing, so Navelbine/Herceptin (considered quite synergistic together) may still be an option for you if you didn't progress while ON Navelbine. Also, Navelbine is considered very effective against lung mets.

I hope some others post with their treatment decisions, as I'm sure you're worried and anxious to put together a plan. Hang in there, you DO have many options still, and I would hope one of them is still Herceptin

<3 Lolly

sarah · 03-18-2006, 07:48 AM

Lolly, (or anyone else with good info)
I've a HER2+ ER- PR- friend who tried Navelbine when her cancer first recurred but her WBC dropped to 8 (I think that's what she said) and despite several injections, it didn't improve so she had to go off it despite its good effect on the cancer. Well now she's got mets in the lung. Any thoughts as to what they could give her so she could go back on Navelbine? She's currently on Caelyx but the cancer markers are not going down.thanks
sarah

Lolly · 03-18-2006, 10:49 PM

Sarah, some people just don't do well with Navelbine; low blood counts have been a problem for me also. We've used a combination of halving the Navelbine dose every other week to keep my white counts just high enouth, and Aranesp for the red counts. Now, though, I'm on permanent half doses, since I started Xeloda. Counts are ok.

I have a friend who couldn't tolerate Navelbine either. Xeloda/Herceptin worked very well for her for a long while for IBC. Another friend with Her2 lung mets reached NED on Xeloda/Herceptin; is your friend still on Herceptin and have they tried Xeloda?!

<3 Lolly

sarah · 03-19-2006, 09:05 AM

thank you for your answers. yes, she's on Herceptin and Caelyx but I'm sure now they'll change to something else. The Navelbine helped the cancer but destroyed her white blood cells. I'll ask her about the other drugs you mention. she sees her onc tomorrow. Also she's in touch with the premiere HER2 doctor in Rotterdam, known as Dr. Her2 so maybe he'll have some ideas also - I hope so.
keep sending any ideas.
many thanks
Sarah

sarah · 03-19-2006, 09:08 AM

Also unregistered, I tried to access this site http://www.cabnr.unr.edu/cabnr/news...onandcancer.pdf but even shortening I only came up with an argricultural site - had no idea where to go. could you explain it more?
thanks
sarah

03-18-2006, 03:00 PM

This is a thought provoking article if you did not see the other post, and may be of interest, in terms of adjuncts to consider.

As with all things it should be treated with common sense, checked, and any changes in diet etc checked with advisors etc.

RB

http://www.cabnr.unr.edu/cabnr/news...onandcancer.pdf

connie · 03-24-2006, 02:03 PM

Shelly,

After being dx'ed with IBC in June 2002, being NED (no evidence of disease) for four years, I have just had a reoccurence to my lung. My treatment has started after a wedge resection of my lung--clear margins but invasion of the vascular lymphatic system.... I am on navelbine/carboplatin/hercepton day 1 & 8, Hercepton also every week, and Xeloda day 1-14 (1500 mg every day).

How are you doing? I am still in the angry, I can't beleive this has happened again mode!!! But trying to but my best foot foreward!

Connie (KY)