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		|  04-07-2016, 09:25 AM | #1 |  
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				IT Herceptin In Europe
			 
 Had First Brain MRI since Surgery and Conformal Radiotherapy.  The resection cavity looks fine.
 The bad news is there is a tumor on the meninges. It's only 2mm big. There are two other tumors. They are 2mmm and 6.7mm.
 
 The Onc spoke to the specialist about Gamma Knife and he didn't recommend it. They said it would probably work now, then come back on a different place on the Meniges later. I am seeking a second opinion on this as I feel deal with what is here now and if something turns up deal with it then.
 
 The onc wants to start perjeta, herceptin and docetaxel now. I can't see how this will work. As none of them reach the brain. They said after surgery and radiotherapy it can break the Blood Brain Barrier down. They said they have had patients with systemic and brain mets before and it has reached the brain.
 
 They have never had anyone in my wifes situation. IT Herceptin isn't available in the UK, I've asked them to look into it and given them info from RolePaul.
 The Onc's said they want to hold back WBRT until if it is needed.
 
 We are based in England and nowhere here does IT Herceptin.  I know France is trialling it now, but not sure if we'll be able to get on the trial.
 
 Does anyone know any places in Europe that do IT Herceptin?
 
 Thanks
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		|  04-07-2016, 01:29 PM | #2 |  
	| Senior Member 
				 
				Join Date: Sep 2005 Location: Stockton, NJ 
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				Re: IT Herceptin In Europe
			 
 Tykerb is a small molecule that crosses the blood brain barrier. The chemos Xeloda and Temodor cross too. 
				__________________Kind regards
 
 Becky
 
 Found lump via BSE
 Diagnosed 8/04 at age 45
 1.9cm tumor, ER+PR-, Her2 3+(rt side)
 2 micromets to sentinel node
 Stage 2A
 left 3mm DCIS - low grade ER+PR+Her2 neg
 lumpectomies 9/7/04
 4DD AC followed by 4 DD taxol
 Used Leukine instead of Neulasta
 35 rads on right side only
 4/05 started Tamoxifen
 Started Herceptin 4 months after last Taxol due to
 trial results and 2005 ASCO meeting & recommendations
 Oophorectomy 8/05
 Started Arimidex 9/05
 Finished Herceptin (16 months) 9/06
 Arimidex Only
 Prolia every 6 months for osteopenia
 
 NED 18 years!
 
 Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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		|  04-07-2016, 01:35 PM | #3 |  
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				Join Date: Nov 2005 Location: Ireland 
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				Re: IT Herceptin In Europe
			 
 I don't know of anywhere myself but while looking into it I came across this story from someone who did have it, if you scroll to the final paragraph he mentions it, perhaps if you contact them they may have more info for you on this.  Sending good wishes. http://www.brainmetsbc.org/en/conten...ngeal-and-brai
				__________________Tricia
 Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
 A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
 Rads x 36 ..oophorectomy August '06
 Currently taking Arimidex..
 June 2011 osteopenia/ zometa x1 yearly- stopped Zometa  2015 as Dexa show normal bone density.
 Stopped Arimidex July 2014- Restarted Arimidex 2015  for a further two years on the advice of my Onc.
 2014 Normal Dexa scan
 2018 Mammo all clear, still NED!
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		|  04-07-2016, 02:41 PM | #4 |  
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				Re: IT Herceptin In Europe
			 
 Thanks, I've already contacted him today, and hope to get a reply.  Thanks for looking. |  
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		|  04-07-2016, 02:43 PM | #5 |  
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				Re: IT Herceptin In Europe
			 
 Thanks Becky, That's the combination I wanted.  It's not available on the NHS in the UK any more.  If I paid for it privately, then we'd never be able to use Perjeta.
 Although, if this doesn't work, It could be the only option.
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		|  04-08-2016, 12:10 AM | #6 |  
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				Join Date: Apr 2007 Location: LA LA Land 
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				Re: IT Herceptin In Europe
			 
 Can you get treated in US, compassionate use? Forgive my ignorance. It's incredible that they aren't able to do IT herceptin and won't pay for you to go elsewhere and get it. Tykerb is relatively cheap now - why would it negate your use of Perjeta? Maybe you don't tell - just try with herceptin? I'm very sorry you are going they this. I wish I was more helpful. 
				__________________1996 cancer WTF?! 1.3 cm lumpectomy Er/Pr neg. Her2+ (20nodes NEGATIVE) did CMF + rads. NED.
 2002 recurrence. Bilateral mastectomy w/TFL autologous recon. Then ACx2. Skin lymphatic rash. Taxotere w/Herceptin x4. Herceptin/Xeloda.  Finally stops spreading.
 2003 - Back to surgery, remove skin mets, and will have surgery one week later when pathology can confirm margins.
 ‘03 latisimus dorsi flap to remove skin mets. CLEAN MARGINS. Continue single agent Herceptin thru 4/04. NED.
 ‘04 '05 & 06 tiny recurrences - scar line. surgery to cut out. NED each time.
 1/2006 Rads again,  to scar line. NED.
 
 3/07 Heartbreaking news - mets! lungs.sternum. Try Tykerb/Xeloda. Tykerb/Carbo/Gemzar. Switch Oncs.
 12/07 Herceptin.Tykerb. Markers go stable.
 2/8/08 gamma knife 13mm stupid brain met.
 3/08 Herceptin/tykerb/avastin/zometa.
 3/09 brain NED. Lungs STABLE.
 4/09 attack sternum (10 daysPHOTONS.5 days ELECTRONS)
 9/09 MARKERS normal!
 3/10 PET/CT=manubrium intensely metabolically active but stable. NEDhead.
 Wash out 5/10 for tdm1 but 6/10 CT STABLE, PET improving. Markers normal. Brain NED. Resume just Herceptin plus ZOMETA
 Dec 2010 Brain NED, lungs/sternum stable. markers normal.
 MAR 2011 stop Herceptin/allergy! Go back on Tykerb and switch to Xgeva.
 May-Aug 2011 Tykerb Herceptin Xgeva.
 Sept 2011 Tykerb, Herceptin, Zometa, Avastin.
 April 2012 sketchy drug trial in NYC. 6 weeks later I’m NED!
 OCT 2012 PET/CT shows a bunch of freakin’ progression. Back to LA and Herceptin.avastin.zometa.
 12/20/12 add in PERJETA!
 March 2013 – 5 YEARS POST continue HAPZ
 APRIL 2013 - 6 yrs stage 4. "FAILED" PETscan on 4/2/13
 May 2013: rePetted - improvement in lungs, left adrenal stable, right 6th rib inactive, (must be PERJETA avastin) sternum and L1 fruckin'worsen. Drop zometa. ADD Xgeva. Doc says get rads consultant for L1 and possible biopsy of L1. I say, no thanks, doc. Lets see what xgeva brings to the table first. It's summer.
 June-August 2013HAPX Herceptin Avastin Perjeta xgeva.
 Sept - now - on chemo hold for calming tummy we hope. Markers stable for 2 months.
 Nov 2013 - Herceptin-Perjeta-Avastin-Xgeva (collageneous colitis, which explains tummy probs, added Entocort)
 December '13 BRAIN MRI ned in da head.
 Jan 2014: CONTINUING on HAPX…
 FEB 2014 PetCT clinical “impression”: 1. newbie nodule - SUV 1.5 right apical nodule, mildly hypermetabolic “suggestive” of worsening neoplastic lesion. 2. moderate worsening of the sternum – SUV 5.6 from 3.8
 3. increasing sclerosis & decreasing activity of L1 met “suggests” mild healing. (SUV 9.4 v 12.1 in May ‘13)
 4. scattered lung nodules, up to 5mm in size = stable, no increased activity
 5. other small scattered sclerotic lesions, one in right iliac and one in thoracic vertebral body similar in appearance to L1 without PET activity and not clearly pathologic
 APRIL 2014 - 6 YRS POST GAMMA ZAP, 7 YRS MBC & 18 YEARS FROM ORIGINAL DX!
 October 2014: hold avastin, continue HPX
 Feb 2015 Cancer you lost. NEDHEAD 7 years post gamma zap miracle, 8 years ST4, +19 yrs original diagnosis.
 Continue HPX. Adding back Avastin
 Nov 2015 pet/ct is mixed result. L1 SUV is worse. Continue Herceptin/avastin/xgeva. Might revisit Perjeta for L1. Meantime going for rads consult for L1
 December 2015 - brain stable. Continue Herceptin, Perjeta, Avastin and xgeva.
 Jan 2016: 5 days, 20 grays, Rads to L1 and continue on HAPX.  I’m trying to "save" TDM1 for next line. Hope the rads work to quiet L1. Sciatic pain extraordinaire :((
 Markers drop post rads.
 2/24/16 HAP plus X - markers are down
 SCIATIC PAIN DEAL BREAKER.
 3/23/16 Laminectomy w/coflex implant L4/5. NO MORE SCIATIC PAIN!!! Healing.
 APRIL 2016 - 9 YRS MBC
 July 2016 - continue HAP plus Xgeva.
 DEC 2016 - PETCT: mets to sternum, lungs, L1 still about the same in size and PET activity. Markers not bad.  Not making changes if I don't need to. Herceptin/Perjeta/Avastin/Xgeva
 APRIL 2017 10 YEARS MBC
 December 2017 - Progression - gonna switch it up
 FEB 2018 - Kadcyla 3 cycles ---->progression :(
 MAY30th - bronchoscopy, w/foundation1 - her2 enriched
 Aug 27, 2018 - start clinical trial ZW25
 JAN 2019 - ZW25 seems to be keeping me stable
 APRIL 2019 - ONE DOZEN YEARS LIVING METASTATIC
 MAY 2019 - progression back on herceptin add xeloda
 JUNE 2019 - "6 mos average survival" LMD & CNS new single brain met - one zap during 5 days true beam SBRT to cord met
 10/30/19 - stable brain and cord. progression lungs and bones. washing out. applying for ds8201a w nivolumab. hope they take me.
 12/27/19 - begin ds8401a w nivolumab. after 2nd cycle nodes melt away. after 3rd cycle chest scan shows Improvement, brain MRI shows improvement, resolved areas & nothing new. switch to plain ENHERTU. after 4th cycle, PETscan shows mostly resolved  or improved results.  Markers near normal. I'm stunned but grateful.
 10/26/20 - June 2021 Tucatinib/xeloda/herceptin - stable ish.
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		|  05-06-2016, 09:36 AM | #8 |  
	| Senior Member 
				 
				Join Date: Mar 2014 Location: Glendale, AZ 
					Posts: 210
				 
		 
		 
		
		 
		
		
	
		
	
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				Re: IT Herceptin In Europe
			 
 SoCalGirls, 
You are an inspiration!!  I was just diagnosed with mets to the pituitary gland.  Having pet scan today, praying for no further mets.  Will do Gamma Knife and pray that it will only take one miracle zap as well 
				__________________Kathy
 38 years old!
 
 January 17th 2014-mammo, ultrasound, biopsy
 January 20th 2014- diagnosed, ER/PR+, Her2+++, Stage 2A
 January 21st 2014-MRI, right breast only plus lymph nodes
 January 23rd 2014- Pet scan-2 cm tumor, 3 lymph nodes
 February 4th 2014-port insertion
 February 12th 2014-first chemo treatment(TCHP x6 cycles)
 May 28th 2014-LAST chemo treatment!!
 July 10th 2014-double mastectomy
 July 29th 2014-start radiation(30)
 Sept. 11th 2014last radiation treatment!!!
 November 12 2014-started Tamoxifen
 January 20 2015-reconstruction begins, lat flap
 February 4 2015-last Herceptin treatment!!
 April 24, 2015- pet scan-NED!!
 June 3 2015- exchange surgery, port removed!!
 September 8 2015-hysterectomy/oophorectomy
 September 15 2015-Revision of lat flap reconstruction
 December 23 2015-nipple reconstruction
 May 9th 2016-Mets to pituitary gland, liver and C7 vertebrae
 May 10th-port put back in:(
 May 17th- biopsy of mass on back
 May 19th-started Herceptin/Perjeta
 May 20th-5 treatments Cyberknife to pituitary gland tumor
 June 9th-Started THP (will have 6 cycles)
 August 17th-MRI of brain, significant reduction in tumor
 😃, repeat MRI in 3 months.  Received first Zometa
 infusion.
 June 24th 2019- Thoracic spine Mets, leptomeningeal Mets , 10 radiation treatments
 Aug 1st- Ommaya Reservoir implanted
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