sad

[lindaw]

Very sad today . My onc said progression on Gemzar and Herceptin( skin mets). I ahve to have scans on Friday. Two more rounds and then move to something else. I am so tired of this - I have had chemo cont since diagnosed in October 2002. I just want to be normal again.

Lindaw

[Shell]

Linda-


I am hoping that today is a better day for you (actually, it must already be because when i saw your post time it said 3:59 am, and i hoped you weren't from the US east coast, as that means you aren't sleepig either!!).

I haven't tried gemzar, as i'm still on xeloda... Is there any chance of your trying tykerb instead of or in addition to the herceptin?

Also, there is a post by Cathy who is looking for info on doxil, and I recall that you had tried that...

Good luck, and I hope you experience a random act of kindness today to lift your spirits...

Shell

[lindaw]

Dear Shell

Thanks for replying.I am in Australia and we are not sure if the compassionate Tykerb is available yet.
I have had a good cry alone and with the family and feel a little better.
I did try doxil but not for lobg as it failed me too.

love
Linda

[cathy34]

get past it, get right back in the saddle and keep going. You have to only have positive thoughts. I'm the Cathy that Shell wrote to you saying I was looking for info on Doxil. It didn't work for you? I hope it will do something for me although I am not too optomistic. I too tried Gemzar and it didn't work for me either. This is all one big guessing game. We're living proof that this is the reason there is no cure yet...cancer is so damn tricky and sneaky.

[heblaj01]

Linda.

Here is a case report on a treatment(Iressa+Herceptin) which appears to work well with a patient having a medical history close to yours:

Induction of remission in a patient with metastatic breast cancer refractory to trastuzumab and chemotherapy following treatment with gefitinib ('Iressa', ZD1839).

Schneeweiss A, Kolay S, Aulmann S, Von Minckwitz G, Torode J, Koehler M, Bastert G.

Departments of Gynecology and Obstetrics, University of Heidelberg, Heidelberg, Germany. andreas_schneeweiss@med.uni-heidelberg.de

Despite new therapies and several treatment options, metastatic breast cancer (MBC) remains incurable. One reason for the low median survival rate may be intense cross-talk between growth factor receptors such as the epidermal growth factor receptor (EGFR/HER1) and the HER2 growth factor receptor. This report describes the case history of a patient with MBC whose disease had progressed despite surgery, radiotherapy and four different chemotherapy regimens, including trastuzumab (a monoclonal antibody that specifically blocks HER2) combined with docetaxel. However, treatment with 500 mg/day gefitinib ('Iressa', ZD1839), an EGFR tyrosine kinase inhibitor, and trastuzumab (2 mg/kg/week) caused a rapid and sustained regression of breast cancer metastases in skin and lymph nodes. Thus, for patients with MBC whose tumors co-express EGFR and HER2, gefitinib in combination with trastuzumab may prevent receptor cross-talk, improving the outcome of MBC.


P.S.

I found a case reported by an onc of a single patient who got skin mets after taking Doxil. There was no absolute certainty that doxil was the cause only a suspicion.

[alw]

I'm sure I am oversimplifying this, but maybe someone can help me out with something that is bothering me.

Given the information we have about cross-talk through the HER family (Her1/EGFR, Her2, and Her3) - is there a reason that oncologists are not routinely testing Her2 positive patients for the other growth factors and treating accordingly (ie with Iressa or Lapitinib or another pan-Her drug)?

Thanks for any help.

Amy

[Kim in DC]

What chemo combinations have you tried? I know a woman who had success with herceptin and avastin for skin mets. I also know a woman who was radiated again

Kim

[lindaw]

Hi All

Thanks for suggestions. I am better having had my feel sorry for me day yesterday. I am so torn between rads and more chemos. I am in Australia and don't thing iressa and avastin are approved here, I would like to try rads but know it can occur just outside the field the day after and can do damage whilst others have had success. It is the confusion and uncertainty that bothers me.

Linda

[judiek]

Linda,


I'm sorry to hear that your disease has progressed again. I am on gemzar now and will find out tomorrow if I have progressed or remained stable. It's always very upsetting to get this news...you have have ready right to be angry, mad and sad. I don't know much about skins mets (I have lungs/liver) but know of some that have had radiation....I don't know your history and I don't know if there is a cap on this kind of radiation. I will be praying that your onc finds a new effective tx plan.

Hugs,

Judiek

Linda,
As of april 2006, Iressa & Avastin were approved for specific cancers in Australia (but not covered for free access) as per article:

http://www.theage.com.au/news/nation...?page=fullpage

Off label prescription is always a possibility if you have a cooperating onc.