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Old 10-01-2009, 04:29 PM   #1
Barbara H.
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I'm off the T-DM1 trial

Hi everyone,
Some of you may remember that I developed a side effect of lung inflammation from this drug. The inflammation was stable for the first half of this year, but my recent CT scan indicated an increase great enough to make the decision to stop this drug. I have been on the drug for two years and it has kept me in remission or stable since bone mets can not be easily measured.

I have to say that TDM1 was a great drug for me and I hope that many of you will have the opportunity to use it in the near future. Since I am the only one who has this side effect, I wouldn't be concerned about it.

I will now probably start Tykerb with Herceptin in about two weeks, although there is a possibility of a trial if I qualify. Since I do not have measurable disease I may not qualify.

I'm not happy, but that's the way it is with stage 4. I'm off to read about the management and side effects of Tykerb.

Best regards,
Barbara H.
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Old 10-01-2009, 04:46 PM   #2
StephN
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Re: I'm off the T-DM1 trial

Dear Barbara -
Gosh! This is a tough break. At least it is not due to progression.

I know just when school is going full tilt again is not when you want to have to change to a drug with more possible side effects.

Was just wondering if you could take a break from T-DM1 such as with Herceptin when we get a LVF drop?? Since this is rare, I still think Genentech needs to take a look at this possibiliity, to see if the inflammation will subside.
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"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 10-01-2009, 06:42 PM   #3
Laurel
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Re: I'm off the T-DM1 trial

I am so sorry you had to leave the trial, Barbara. I am hoping this set back will lead you to something even better for you. Your are very positive and upbeat. I admire those qualities in you as you face this fight! Praying for the Tykerb and Herceptin keep you stable!
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Laurel


Dx'd w/multifocal DCIS/IDS 3/08
7mm invasive component
Partial mast. 5/08
Stage 1b, ER 80%, PR 90%, HER-2 6.9 on FISH
0/5 nodes
4 AC, 4 TH finished 9/08
Herceptin every 3 weeks. Finished 7/09
Tamoxifen 10/08. Switched to Femara 8/09
Bilat SPM w/reconstruction 10/08
Clinical Trial w/Clondronate 12/08
Stopped Clondronate--too hard on my gizzard!
Switched back to Tamoxifen due to tendon pain from Femara

15 Years NED
I think I just might hang around awhile....

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Old 10-02-2009, 06:46 AM   #4
Lori R
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Re: I'm off the T-DM1 trial

Dear Barbara,
Sorry to hear about this rare side effect. We all know how special you are but now was not the time to be unique.

Who would make a decision about taking a break and then possibly going back on T-DM1? Would you need to wait until the drug is FDA approved and then approach your Onc?

There are many more chem options, possibly use them, keep the mets stable and then jump back on in 2010.

Cheering you on!!!
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2007
Oct - Diagnosed - Stage IV
5 c.m. IDC - Left Side er/pr- Her2+++
Node + 2/14 - Single Liver Met
Double Mastectomy
Nov - Begin T+H
2008
Feb-Complete 6 cycles- T&H- NED
March - Continue - Herceptin Only
April - Rads for 6 weeks
2009
Continue Herceptin - Continue NED
April - Recurrance- 3 cm. Liver Met
May - Cryosurgery
June - November - Abraxane + Herceptin
Aug - PET/CT - CTC = 0 Back to NED
2010
January - Continue NED
July - Recurrance - 3 cm Liver Met CTC=1
August - Cryosurgery #2
August - November Navelbine
November - Back to NED - End Navelbine
2011
Feb - Recur - 4 cm Liver Met - Same Left Lobe
March Surgery it is -Couldn't get a clean margin
July - Confirmed continued liver involvement
August - Begin Herceptin + Tykerb
October - Mixed results from H+T
Add Abraxane + H + T - Nov - April
2012
January PET Scan - It's working!!
April - Back to NED
July - Recurrance
August - Begin TDM-1 Trial (Taxol + TDM-1)
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Old 10-02-2009, 09:04 AM   #5
chrisy
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Re: I'm off the T-DM1 trial

Barbara,
Sorry to hear this - you hate to get off a "winning horse" and DM1 seemed to be giving you a great ride. Now it seems you will again be blazing a new trail with the Herceptin/Tykerb - or whatever is next. I look forward to hearing your reports.
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June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?"
9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++
10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!
04/05 - 4/07 Herception every 3 wks, Continue NED
04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial
06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin
01/08 Progression in liver
02/08 Begin (TDM1) trial
08/08 NED! It's Working! Continue on TDM1
02/09 Continue NED
02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED
12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver
07/11 - 11/11 Herceptin/Xeloda -not working:(
12/11 Begin MM302 Phase I trial - bust:(
03/12 3rd times the charm? AKT trial

5/12 Scan shows reduction! 7/12 More reduction!!!!
8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!)
9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3
11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc
11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go.
2/13 Gemzar/Carbo/Herceptin - no go.
3/13 TACE procedure
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Old 10-03-2009, 04:49 AM   #6
Pam P
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Re: I'm off the T-DM1 trial

I am disappointed to hear that you can't continue in this trial. And I hope you will be able to return to this drug once it's off trial. In the meantime herceptin/tykerb combo hopefully will keep everything stable or better while your inflammation can resolve. If this lung inflammation is rare - are they sure it was caused by the t-dm1 or possibly some other non related cause?
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6/01 IBC er+ her2+stage IIIb; mastecomy
7/01 AC, taxol; radiation
2/02 tamoxifen
9/02 stage IV bone mets femara
1/03 taxotere/herceptin/aredia
6/03 herceptin, aredia & faslodex
1/04 navelbine, herceptin, aredia
2/05 herceptin/aredia
7/05 xeloda/herceptin/aredia
3/07 xeloda/tykerb/aredia
5/08 taxol/avastin/aredia
2/09 gemzar/herceptin/zometa
7/09 Taxol/Carbo/Herceptin, zometa
10/09 navelbine/herceptin & zometa
2/10 herceptin & tykerb & zometa
4/10 add xeloda &aromasin
10/10 dx with dermatomyiositis triggered by cancer
11/10 restart herceptin, tykerb, zometa
12/10 surgery-place rod in R femur to stabilize bone
1/11 radiation to R femur - 20 tx
2/11 2nd surgery - rod in Left femur
2/11 tx eribulen -- suspended dx brain mets
3/11 brain mets wbr 20 tx
4/11 halaven; discontine 8/11 not working
8/11 radiation to left femur 20 tx'
8-9/11 rad to lower spine
9/11 abraxane/herceptin/zometa
9/12 xeloda/herceptin/zometa
12/12 ablation of liver
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Old 10-03-2009, 08:05 AM   #7
Barbara H.
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Re: I'm off the T-DM1 trial

HI Pam,
I had a lung biopsy last November that determined that it was inflammation that was probably caused T-DM1. I had many CT scans since I started the trial two years ago and the initial scans did not show this inflammation.
Thanks for your concern.
Barbara H.
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Old 10-03-2009, 09:57 AM   #8
Joan M
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Re: I'm off the T-DM1 trial

Barbara,

Sorry to hear that you're off the T-DM1 trail.

You really had a good run with the trail, and I hope it's effects last and that your lung clears up.

Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2023 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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Old 10-03-2009, 12:25 PM   #9
AlaskaAngel
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Question Re: I'm off the T-DM1 trial

I am sorry that problem has cropped up for you, Barbara.

I may not be current about this so take it with a grain of sand, but I think for some, lung inflammation may have been one side effect of lapatinib (Tykerb) as well.

Can those who have been on Tykerb comment on that?

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Old 10-03-2009, 06:45 PM   #10
Barbara H.
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Re: I'm off the T-DM1 trial

Lung inflammation is a side effect of Tykerb and that worries me. However, it is also a side effect of Herceptin and I never had that problem when I was just on Herceptin.
Barbara H.
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