Chemo options for brain mets after CyberKnife

[Emmay]

We met with my sister's neuro-oncologist, who suggested a combination of Temodar/Sorafenib. The Sorafenib (also known as Nexavar, and "a sister compound" of Sutent) is an antiangiogenesis drug. I asked about the combo of Temodar/Xeloda, and she said that might be another option, but the neuro-oncologist is seeing some very early encouraging results with Sorafenib/Temodar combo. She said they are "radiation sensitizers", so she would like my sister to start the protocol(if she choses it) before her next CyberKnife treatment.

The most common side-efffect of Sorafenib seems to be a rash on the hands and/or feet, which subsides when treatment is interrupted, and sometimes doesn't return when treatment is started up again. Pattyz, what side effects have you experienced on the Temodar/Xeloda combo? Thank you very much.

[pattyz]

Emmay,

I am so impressed with your sister's doctor/s. So many just 'give up' and say there is nothing left to do...

My side effect, given my dosage and schedule, from the Xeloda/Temodar is just fatigue and feeling 'icky' for a few days. I do take Zofran to avoid nausea caused by the Temodar. The only time I forgot the Zofran, I was up in the wee hrs, throwing up... And 200mg of B-6 'just in case' for potential H/F syndrome.

My oncologist devised my dose and schedule for me. Can't remember if I told you the details, but think I did. Will do so again if you need that info.

I want to thank you for the information you have provided here, as well. I am saving this to give to my own onc.

Staying hopeful,
hugs to you both,
pattyz

[heblaj01]

Emmay,
For possible future use get a look at Panzem article at
http://www.entremed.com/download/pre...b_FINALOUT.pdf

While the article is on gliomas, not brain mets from breast, the fact that Panzen (not yet approved) has antiangiogenesis properties & several other modes of action & is usable alone or in combination with Temodar makes it a drug with potential wide applications.
Clinical trials are mentioned (current & in 2007)

[Emmay]

I should clarify that the early encouraging results that my sister's neuro-oncologist is seeing is with patient(s?) melanoma metastasis in the brain, but since melanoma mets are notoriously difficult to treat, she is hopeful that the Temodar/Sorafenib combo may be helpful for breast cancer mets to the brain as well. As I learn more, I will post here.

Pattyz, thank you for the info on your physical tolerance on the Temodar/Xeloda combo, and the use of Zofran as well as B-6. I know my sister was on an anti-nausea med when she went through her first round of chemos, AC+T, in'04, and she did well with that.

Heblaj01, thank you for the link on Panzem -very interesting - the more new meds being tested in the pipeline the better, and the more hope for all of us.

Wishing everyone sustained good health and much love and peace for the holidays and the coming new year.

[Shahyan]

Hi,


I would also suggest Gemzar w carboplatin and Herception which is what my mother is on and she has shown a 50% response, with the Grace of God. I however, feel that her supplements i.e. Boswella Serrata has also been a great help.

Hope this helps

[Annemarie]

I have had brain mets 3 times. NED else where in the body. Herceptin seems to be doing its job there. I take Temodar monthly and Femara. I am looking forward to Tykerb. I am a seven year survivor.

[heblaj01]

To the info I reported in a previous post in this thread regarding Panzem, here are some dramatic pictures of the efficacy of the Panzem+Temodar combo in mice: see pages 12 & 13 at http://www.entremed.com/download/pdf...esentation.pdf

This combo is in phase 2 clinical trial at Duke University & is still enrolling patients.