Question: low dose Herceptin

[bluesigo]

Hello, Does anyone have experience using a decreased dose of Herceptin to manage side effects while obviously maintaining efficacy? My wife has been metastatic for 5 years (liver). December 2011 she had a Cyberknife tx to the largest met followed by 4 months of Doxil to tx smaller liver mets followed by Herceptin alone which began April 2012. Scans progressively improved month after month to essentially NED (doctor won't say that though) and CA 27/29 is now 21.

Herceptin has been a mainstay of her treatment regimen for years and appears to be exceptionally effective. However, her side effects are becoming worse, specifically extreme fatigue, very significant full body pain and GI fx. The side effects are definitely dose related as she cannot tolerate the higher every 3 week dose.

On Monday she will try standard weekly doses for a month but I suspect this will not have any affect on the side fx. I believe the decreased tumor burden, hence more free herceptin, is responsible for the problems she is experiencing. So, I'm asking, does anyone have experience using lower than standard dosing to manage side fx?

Thanks to all.