Taxotere vx. Adriamycin?? I start Friday - yikes!

[Donna]

Hello Amazing Ladies, and Men,

I am supposed to start on Adriamycin and Cytoxan on Friday. Just in the last couple of days I am reading that long term studies (22 years) have just shown that Adriamycin does damage to the heart that doesn't show up until later and progesses over time to be pretty significant.

I also read that in Dec. 2005 at the San Antonio conference it was put forth that Taxotere/Cytotoxan was gave better results than A/C and didn't have the heart problem associated with it. I am trying to get a call from my oncologist, but I just wondered if anyone here might have that experience or information.

It just seems since Herceptin is potentially bad for the heart that taking extra chances with Adriamycin would only be a good idea if it were absolutely the proven best thing out there. Then the risk becomes acceptable.

I just want to be 100% confident in the treatment I am receiving so that I can keep that mental picture necessary for this to be a healing regimen with no reseravations.

Anyone know about any of this?????

Thanks so much!

also, anyone live where it is cool now? this heat wave here is awful! I live in No. California just outside of Sacramento - mayve the cancer will just get boiled out of me :-)

[Sherryg683]

My Oncologist said ABSOLUTELY NO WAY would he give me Adriamycin with Herceptin (at the same time). He said it has been known to cause heart attacks, puts too much strain on the heart. I was put on Taxotere, Herceptin and Xeloda and it worked great... my lung mets were gone at my 6 weeks scan. Now if your Oncologist is planning on giving you Herceptin AFTER he finishes the Adriamycin, then I guess that's different. My Oncologist told me that with the newer drugs Adriamycin will be a thing of the past, although I still see a lot of that red stuff in drips at the clinic when I get my Herceptin....sherryg683

[tousled1]

Donna,

I had 4 rounds of A/C and then 4 round of Taxatore. Finished in May and am now on Herceptin. Herceptin can cause your LVEF (left ventricle ejection factor) to drop but when you go off it comes back up to normal. When you are on herceptin your oncologist will order a MUGA or echo-cardiogram every 3 months to check your LVEF. If it drops below 50 you must stop herceptin for a few weeks. I have had no heart problems from the adrymiacin/cytoxan combo followed by Taxatore. Good luck to you.

[CPA]

Donna,

There has been much discussion on several threads about this topic. It appears to be rather fluid as to the "best" combination of chemo drugs. New developments like herceptin and even tykerb make the choice even more difficult.

My wife went through the same dilema as you. Our main medical oncologist in central PA sent us to a consult at facility in Pittsburgh, PA. After a lot of discussion with the oncologist in Pgh, we decided to do an alternative adjuvant regimen of Carboplatin and Taxotere with Herceptin.

The biggest problem (one of them anyway) is that there are no long term survival numbers for the varrying chemo regimens when herceptin is added - at least for early stage adjuvant treatment. There are also no long term comparisons of cancer v. cardiac when known cardiac damaging drugs are used in adjuvant tx for early stage disease.

There is suggestion that some sub-groups (topo 2 for example) of cancer respond much better to a regimen with Adriamycin and Cytoxan while other cancers do not show better outcome. Unfortunately, the tests for the sub groups are not widely available.

My suggestion is to learn as much as possible and express your concerns to your oncologist. He/She should respect your wishes and be able to explain the various risks & rewards of the different options.

It is good to hear that you are trying to get a good mental picture. I am very proud of my wife throughout her treatments. She was mostly able to stay positive - everybody has an occasional bad day. We are over half way through the year of herceptin and we are nervously awaiting all of her scans in November.

Good luck and visit the boards often. I have learned a lot here and found many good resources.

[StephN]

Hi -
There is a gentler form of Adria (Big Bad Red as we called it when I took it) called Epirubicin. You may want to pursue something like this.

ALso the Adria is usually hand pushed to enter your body at a rate where it takes from 17 to 20 minutes.

Adriamycin and Taxotere did not work for me - I progressed to stage IV within 6 months after taking these drugs. I blame it on the TOPO II thing. This was not researched yet when I was treated with those drugs.

[Lani]

I attended the talks in San Antonio and I believe the results from TCH were slightly worse than the AC, TH...but the data were not "mature" (trial hasn't gone on long enough for meaningful differences) and it was unclear if the difference would end up to be significant. Importantly, there was much less cardiotoxicity when Adriamycin was left out.

It seemed from there data that Adriamycin only added something if the tumor was TopoII +.

There is a way to get Topo II tested. Jean from this board went to Dr Slamon and he arranged to have her tumor specimen sent to USC for the test to determine if TCH was likely to be just as good (or close to it) as AC, TH ie, it would be if TOPO II was negative.

It seems to be pushing the envelope of soon to be state of the art. Do you want to go there or are you just as happy not to know your TOPO II status? If you do, perhaps Jean could provide you with the info

[Monica]

I took A/C then taxol/herceptin. I do believe the adriamycin permanently damaged my heart. My muga scan dropped permanently and now I periodically have arrythmia (sp?) which I never had before. If you have other alternatives, I would definitely opt for those.
Best,
Monica

The results of the study headed by Dr. Slamon testing TCH vs. ACTH are available in a thread on this site. In June, they published the 4 1/2 year results with the ACTH being more effective than TCH. Dr. S indicated that TCH was a good alternative for people with pre-existing heart problems who don't want both A and H.

My onc sent a specimin to USC for topa2 testing and it came back positive, so I did AC followed by TH. I haven't heard any evidence that AC damages the heart permanently. My EKG came out fine afterward. I'll be tested again after 3 months of Herceptin. Though very few people show heart damage with Herceptin, it does not seem to go away with time so far in the trials.

Hope this helps,
Dilly

Hello Donna. I had Adria/Cytoxen/Taxotere & Zometa as the big gun brew for stage 4 (mets to liver & spine). Liver mets shrunk over 50% after 3 cycles, however I developed neuropathy in fingers and toes - probably from the Taxotere (taxanes may do this). My heart function dropped from 75% to 65%.
My onc decided to get me on Herceptin/Taxotere weekly for 3 weeks with Zometa one time and then 2 weeks off to recoup. (ordinarily is 1 week rest)
I have been on this tx for 3 'cycles' and will undergo muga, liver panel & probably full body ct scan to see how mets are doing for size. (i have faith they are zapped!)

Throughout my tx I have taken supplements to boost my system - vitamins A,C, D,E and B complex. ALoe Vera for healing and CoQ10 for the heart. I feel it is VERY important to put good things into your body too by eating 'healthier'.
For my mental wellbeing I have Reiki sessions, and try to meditate.

There is alot of info in this site - these people helped me thru. Good luck!!