Intrathecal (IT) Herceptin (Trastuzumab) for brain mets (Leptomeningeal Metastases)

[evlin75]

Depocyt is what my daughter is receiving IT and it cannot be mixed with Herceptin. Dr wanted to take her off Herceptin, but I feel it still can work now since the ommaya is in place. Maybe the LP did not give good perfusion. The Depocyt can b given every two weeks and then even farther apart later. The reason we had to go to it, is there was much progression and we needed to have some immediate relief. No obstrutions yet and that is good. So she is getting the Herceptin on alternate weeks.
The Depocyt is caustic and tends to inflame the tissues so steroids are also used. My daughter did have quite a reaction with the first treatment and was hospitalized to get it under control. The doctor then ordered more coverage of the steroids.
A VERY difficult nd trecherous path but we still have hope of knocking this down.

[Rolepaul]

The ability to decide on what path to take for treatment is difficult. I do not think that there has been a suitable dose to allow successful treatment at the 80 mg dosing. We did not see progress with Nina until there was 10 doses at 80 mg for 62 kg Nina. We actually saw additional improvement at 100 mg for 65 kg. This 1.5 mg/kg dosing was also important for Carol, Mario's wife. It does not occur in 2 weeks, but in 10-16 weeks. It should however, stop progression of the disease immediately. Any edema is probably due to the cancer cells dying. Do not give up. Depocyte is really hard on the brain. I am in the business of making these drugs, you want to use a monoclonal Antibody if at all possible.
Superior Paul

[evlin75]

Hi Paul,
We sure did not want to go to this, but the doctor said it had increased along the spine all the way plus extra growths in the lumbar, thorax and several in the cerebellum. He said he was afraid it was going fast enough that it might get past his ability to handle it.
Hopefully we can keep adding the Herceptin and increase the herceptin as the doses of depocyt get further apart.
He said the herceptin with the topotecan was not working.
Thanks for the input.
Ev