TDM1 for HER2+ brain mets reocurrence?

vqtilley · 04-21-2015, 07:50 AM

The current Northwestern study is presently described as a dosage study. Is this dose range (below) lower than the the one you chose? May I ask what dosage you did choose?

"The initial phase of this study will be a dose escalation trial of 3-6 patients per each dose level. Dose escalation will occur until the MTD or the maximal defined dose (MDD) (40 mg) is reached. The starting dose will be 10 mg for cohort 1, 20 mg for cohort 2, 30 mg for cohort 3 and 40 mg for cohort 4. Patients will be treated twice a week for 4 weeks, then once a week for 4 weeks, and then every 2 weeks. The starting dose is based on the safety of this dose and higher doses as reported in the literature. The MTD or MDD will be used for phase II."

Certainly my priority is to avoid WBRT as long as possible.

Rolepaul · 04-21-2015, 09:19 AM

Nina and others started at 40 mg weekly for a four week period. This lets the easy to kill cells die and causes less of need for steroids. Then bump it to 1.6 mg/kg to get the rest of the cells. For Nina at 60 kg, 142 lbs, we went to 80 mg and then 100 mgs. Every week from February 4 2012 to July 1 2012 at 80 mg, then 100 mg every two weeks for six months, then 100 mgs every four weeks for past 28 months. So quite a bit different. The cost of the treatment is dependent upon the hospital being able to use the remaining amount of Herceptin in the vial on another patient. This can also be used for the systemic in some settings. With Nina, we went to systemic Herceptin and navelbine from March 2012 to August 2012. Then just herceptin from August 2012 to August 2014. Switched to TDM-1 August 2015 because of a hot lymph node, which then went cold by October 2014.
I have a good relationship with the treating physicians and they will run outside the lines for me.
There are people that stay inside the box, there are people that go outside the box, and there are a few of us that found if you stand on the box you get a better view. But it means that you sometimes have people throw more rocks at you.