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Re: perjeta with gemzar?
Hi Coolbreeze.
I too am starting a 'novel' combination having had herceptin and carboplatin yesterday I will add perjeta (compassionate) use next cycle. The have been no studies on this but my understanding is the belief that a dual blockade is more effective than a single agent - adding a chemo is the bonus. I've had no platinum exposure which is the reason for going with this rather than Abraxane.
I just came off trial for tdm1 which was ineffective for me - well it slowed the cancer down but didn't stop it. If I wasn't on trial the onc said he would like to add something to it - perjeta or avastin or tykerb.
My private onc was initially a little apprehensive about the carbo preferring the Abraxane but on thinking said the platinum therapy was worth a try for me despite the luck of study into this combination. I feel we are somewhat limited by the studies as they need large groups that will give them their best results - so of course they are going to try first line and with a taxane - but that doesn't mean those of us who have been heavily pretreated will not have a response too in a different combination. They just have to get the drugs over the line with the FDA. The study just hasn't been done yet and who know may now not be - it will be up to those practicing to be guided as to what will be best for the individual patient. Here in Australia once you had tried herceptin then given tykerb a go, you have only recently been allowed back on herceptin - because there was no study saying it would help. You still have to jump through hoops to get it without a taxane.
I'm glad you are giving it a go. I have a goal to see my son finish school too - the catch for me is he doesn't start prep for a couple of weeks - lofty ambition hey? Who knows - maybe something will work a little better for a bit longer and then something better again. I may be living in the clouds but currently I'd rather that.
I hope the treatment is gentle with you. A xx
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Amanda xx
40 year old Mum to three gorgeous kids - son 5 and daughters 8 and 11
Wife to my wonderfully supportive husband of 17 years!
22 February 2011 - Diagnosed Early Breast Cancer IDBC Stage2b (ER/PR -ve, Her2+ve +++) - 38 years old
(L) skin sparing mastectomy with tissue expander, axilla clearance (2/14 affected) clear margins.
Fec*3, Taxotere and herceptin*2 - stopped due to secondary diagnosis
June 24 2011 Stage IV - Skin met, axilla node, multiple lung lesions
Bolero3 trial - Navelbine, Hereptin weekly, daily Everolimus/Placebo
February 2012 - July 2012 Tykerb and Xeloda - skin mets resolved, Lungs initially dramatically reduced but growing again
August 2012 (turn 40!) tykerb and herceptin (denied compassionate use of TDM1) while holidaying in Italy!
September 2012 - January 2013 TDM1 as part of the Th3resa trial - lymph nodes resolved, lungs slowly progressing.
January 2013 - herceptin, carboplatin and Perjeta (compassionate access)
April 2013 - Some progression in lungs and lymph nodes - Abraxane, Herceptin and Perjeta
July 2013 - mixed response - dramatic reduction of most lung disease, progression of smaller lung nodules and cervical and hilar nodes - ? Add avastin.
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