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Old 10-28-2007, 07:45 PM   #1
Cannon
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Red face Hi I'm new here/ Q re length of Herceptin treatment

Hi everyone, I have been reading the boards for a while and I thank you for all the information and support you share. I already know to thank Joe and Christine for making this place available for all of us. Thank you!

My details are in my signature (which hopefully will show up).

My question is about the length of treatment with Herceptin. As I understand it, some folks who are stage IV are on it indefinitely. And the reocmmendation for "early" cancer is one year.

Since I was Stage III, I feel like I'm somewhere in a no man's land. And of course, I am nervous about the idea of stopping it. My oncologist (who I love) is researching it and thinking about it, and I am looking for whatever wisdom you all have here. Thanks.
__________________
Dx 8/06 Age 43 Stage IIIA multifocal throughout breast, largest tumor 5 cm, grade 3, comedo, ER+PR+HER+++
Neoadjuvant A/C 4X Dose Dense
11/06 Bilateral Mastectomy (no choice on the right, my choice on the left)
Taxol+Herceptin weekly x12, continuing with Herceptin, finished one year in 12/07
33 Rads
Femara for 5+ years, staying on (started with Arimidex, switched after about a month, much happier)
Abnormal brain MRI shows no cancer, but "extensive white matter diease" - unknown cause
BRCA negative - lots of cancer in my family
survivor of thyroid cancer
also have Crohn's disease
CT and bone scan say NED as of 5/13
dx with severe cardiomyopathy 5/12 (likely due to chemo and Herceptin), ejection fraction in low 20's, now up to 40, went to 50, latest read 12/13 is back down to 35
1/13 Acute pancreatitis - are you kidding me?
9/13 started Humira for Crohn's. starting to have some energy again
B12 and Vit D both needed supplementation
Cataracts in both eyes noted 6/12 - surgery in the next 2-4 years?
4/14 Kidney stones/blockage/infection - related to Crohn's Disease
5/14 My aunt passed away - she was diagnosed after I was with Stage I - not Her2+, then Stage 4 for about one year
6/14 Scans - still NED, thank God. However, broken rib (I didn't notice) lots of bone degeneration osteopenia/osteoporosis. I also still have cardiomyopathy secondary to chemo.
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Old 10-28-2007, 08:24 PM   #2
Bev
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More study info should be released either this Dec or next spring. Maybe you could try to stay on it til the info becomes available. For early stage there is lot's of data that supports a one year run. Can't say I've seen anything geared specifically to stage 3. Good luck. BB
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Old 10-28-2007, 08:39 PM   #3
sassy
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I too am a triple positive stage III. You can see all my info in my signature. The standard for stage III is the same as "early", which is one year. My onc kept me on for 18 months--we were hoping for the results of the two year trials. He found early info on the two year study indicating that two years was not statistically significantly better than one year, so we stopped at that point. I'm comfortable with the amount of Herceptin I received--even though at first it felt like my "security" was gone.

Were you post menopausal when diagnosed? I ask because I am taking Lupron to stay in menopause and am interested in what others are doing.

Sorry you had to join this group, but you will find great information and support.

My best to you.
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Rhonda (Sassy)
dx age 45
DX 2/15/05 Stage IIb (at surgery)restaged IIIa
Left mast .9cm tumor 5 of 14 nodes
Triple Positive
4 DD A/C
12 Taxol/Herceptin
33Rads
Strange infect mast site one year aft surg, hosp 1 wk
Herceptin for total of 18 months
Lupron Monthly 4 yrs
Neurontin for aches, pains and hot flashes(It works!)
Ovaries removed 11/09 stop Lupron and Neurontin
Arimidex 6 yrs (tried Femara, no SE improvement)
Tried Exemestane-hips got so bad could hardly walk
Back to Arimidex for year seven
Zometa 2X Annual for 7years, Lasix
Stop Arimidex 5/13
Stop Zometa 7/13-Bi-lateral Stress Fractures in Femurs from Zometa
5/14 Start Tamoxifen
3/15 Stem cell transplant to stimulate femur bone growth/healing
5/15 Complete fracture of right femur/Titanium rods both femurs
9/16 Start Evista stopTamoxifen
3/17 Stop Evista--unwelcome side effects!
NED and no meds.......
14YEARS NED!

Last edited by sassy; 10-29-2007 at 07:48 PM.. Reason: info from Becky
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Old 10-28-2007, 08:59 PM   #4
Cannon
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Hi Sassy, I was premenopausal and chose to have my ovaries removed at same time as mastectomy. I had already had a hysterectomy due to fibroids and lots of bleeding. There is some indication that aromatase inhibitors are better for HER+ than tamoxifen, and you can only take those post-menopausal, or suppressed, as I guess you are. I am in general willing to get rid of any superfluous parts at this point. No thyroid, no uterus, no ovaries, no breasts, no appendix, no 6 foot or so of intestine - at this rate, you'd think I would weigh nothing. Not true!
__________________
Dx 8/06 Age 43 Stage IIIA multifocal throughout breast, largest tumor 5 cm, grade 3, comedo, ER+PR+HER+++
Neoadjuvant A/C 4X Dose Dense
11/06 Bilateral Mastectomy (no choice on the right, my choice on the left)
Taxol+Herceptin weekly x12, continuing with Herceptin, finished one year in 12/07
33 Rads
Femara for 5+ years, staying on (started with Arimidex, switched after about a month, much happier)
Abnormal brain MRI shows no cancer, but "extensive white matter diease" - unknown cause
BRCA negative - lots of cancer in my family
survivor of thyroid cancer
also have Crohn's disease
CT and bone scan say NED as of 5/13
dx with severe cardiomyopathy 5/12 (likely due to chemo and Herceptin), ejection fraction in low 20's, now up to 40, went to 50, latest read 12/13 is back down to 35
1/13 Acute pancreatitis - are you kidding me?
9/13 started Humira for Crohn's. starting to have some energy again
B12 and Vit D both needed supplementation
Cataracts in both eyes noted 6/12 - surgery in the next 2-4 years?
4/14 Kidney stones/blockage/infection - related to Crohn's Disease
5/14 My aunt passed away - she was diagnosed after I was with Stage I - not Her2+, then Stage 4 for about one year
6/14 Scans - still NED, thank God. However, broken rib (I didn't notice) lots of bone degeneration osteopenia/osteoporosis. I also still have cardiomyopathy secondary to chemo.
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Old 10-28-2007, 09:51 PM   #5
Vanessa
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Hi, welcome to the site, even though I am sorry you have to be here. I am stage iv, so I was going to be on Herceptin indefinately, but I am now moving on to Tykerb and my dr. will possbly add Herceptin again later. Best wishes for your treatment. I hope it goes well.
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Old 10-28-2007, 10:04 PM   #6
Connie Jean
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Hi
I was on Herceptin for 18 months. It was such a security blanket for me and I felt fearful of ever ending it. My onc was going to continue it until the 2 year mark. But he suggested trying Tykerb, as it is a small molecule that passes the blood brain barrier. The program "Tykerbcares" got my insurance to cover it. I have been on it for 3 months now. I am one of a handful of his patients on it as a preventative to recurrance. I will have my 6 month scans in December and will hopefully continue to be NED.
Life is good.
Connie
__________________
Diagnosed 4/05
Stage IIIc
Triple positive
Epirubicin/Cytoxcin 6x
Mastectomy and reconstruction (Diep Flap)
Taxotere/Gemzar/Herceptin 6x
Rads 28 with boost
Herceptin 18 months
Tykerb
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Old 10-29-2007, 03:41 AM   #7
Becky
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I am going to San Antonio (Breast Cancer Sym) in December and I received the agenda. The 2 yrs of Herceptin HERA trial data will NOT be presented.

I just wanted to make sure one doesn't wait for this data date as it won't be then.
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Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 10-29-2007, 04:02 AM   #8
Cannon
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Smile

Thanks everyone. I had definitely not heard of using tykerb prior to a recurrence, Vanessa. I'll let you know what my onc comes up with.
__________________
Dx 8/06 Age 43 Stage IIIA multifocal throughout breast, largest tumor 5 cm, grade 3, comedo, ER+PR+HER+++
Neoadjuvant A/C 4X Dose Dense
11/06 Bilateral Mastectomy (no choice on the right, my choice on the left)
Taxol+Herceptin weekly x12, continuing with Herceptin, finished one year in 12/07
33 Rads
Femara for 5+ years, staying on (started with Arimidex, switched after about a month, much happier)
Abnormal brain MRI shows no cancer, but "extensive white matter diease" - unknown cause
BRCA negative - lots of cancer in my family
survivor of thyroid cancer
also have Crohn's disease
CT and bone scan say NED as of 5/13
dx with severe cardiomyopathy 5/12 (likely due to chemo and Herceptin), ejection fraction in low 20's, now up to 40, went to 50, latest read 12/13 is back down to 35
1/13 Acute pancreatitis - are you kidding me?
9/13 started Humira for Crohn's. starting to have some energy again
B12 and Vit D both needed supplementation
Cataracts in both eyes noted 6/12 - surgery in the next 2-4 years?
4/14 Kidney stones/blockage/infection - related to Crohn's Disease
5/14 My aunt passed away - she was diagnosed after I was with Stage I - not Her2+, then Stage 4 for about one year
6/14 Scans - still NED, thank God. However, broken rib (I didn't notice) lots of bone degeneration osteopenia/osteoporosis. I also still have cardiomyopathy secondary to chemo.
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Old 10-29-2007, 09:51 AM   #9
Linda
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Hi Cannon:
My dx is close to yours, except that I'm older (52 at dx) I was stage 3a after neoadjuvant chemo, same treatment, etc. However, I'm hormone neg, so fewer weapons post initial treatment. I asked the same questions at the end of my herceptin year. My onc was ready to extend the herceptin, and called "her experts," -- a couple of docs who'd been part of the orginal herceptin trials for more info. She was told that, as the others wrote, there was no shown benefit for 2 years of herceptin (unless you're stage 4, obviously.) My doc also said that the fact that we're not hearing more about 2 year trials indicates that there haven't been results warrenting news or change in protocol. So I stopped after one year and have been fine.
Anyway -- there's one more bit of info for you! December is around the corner, so maybe you'll find out more.
Linda
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Old 10-29-2007, 07:42 PM   #10
G. Ann
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Good luck gathering info for Stage 3. Your onc sounds engaged and that's great. I hope you come up with a good plan.

On a lighter note, I love your dog's picture! What is her/his name, age, etc.? Pets are so good to help keep our spirits up. We've had black Labs in the past and now have an "Aussie." If I knew how to post a picture, I'd show you "my little guy."
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G. Ann
DX 2/04, mastectomy, 2.5 cm tumor, grade 3
Her 2 positive, 60%, 3+/strong, ER/PR-
Stage 2, 0/18 nodes
TX 4 AC (no taxanes, no radiation)
Hysterectomy 10/04
Began Herceptin 1/06, finished 1/07
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Old 10-29-2007, 08:06 PM   #11
DonnaD
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Cannon,
Just to add a little more to what Becky said. I went to a Genentech sponsored HerStory last week. The info I got there was the earliest the two year HERA trial would be presented is the spring of 08.

I am finishing Herceptin in Dec. and would like have a continuous treatment if they say 2 years is better. I am already nervous about no treatment!

Love your dog.
Donna
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Donna
Crystal Lake, IL
Diagnosed 8/4/06 at age 54
Lumpectomy 8/30/06
Stage llA, grade 3, ER/PR-, Her2++
1.7 cm tumor, 1+ lymph node out of 9
Completed 4 A/C, & 4 Taxol with Herceptin
36 rads completed 5/16/07
Mammograms, 7/07 clear
fractured ribs in radiated area 10/07
Finished Herceptin 12/27/07
Mammogram,CT,tumor markers 1/08 - small lung nodules in radiated area, repeated tests 3/08 stable
Mammogram,CT ,tumor markers 6/08 stable
NED 2 years!!
3 years !!!
4years!!!!
4 years, 10 months and 8 day NED, calling it 5 years!!!
Official 5 years 8/30/2011
8/31/ 2012 - 6 years!!!!!!
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Old 10-30-2007, 08:20 PM   #12
Cannon
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Smile My onc's answer

Hi again - thanks for all the love for my dog - it's actually his name that is Cannon, I borrowed it for my username. He's 7 and a total love. He was supposed to be a guide dog, but honest-to-goodness, he's afraid of cats, so they failed him (they call it "career-changing").

Saw my onc today and he said he would not recommend continuing on Herceptin past a year, with me not being Stage IV, and given the possibility of cardio-toxicity. I got the impression if I had pressed, he probably would have continued a little longer, but I'm pretty sure I'm ready to risk it.

He did tell me that he knew of another drug (for a different disease, not sure if it was even a cancer) that had a similar gene-modifying effect - or whatever it is that Herceptin does - that they could not get enough people to go off for a good A/B test. But some patients did take themselves off it, and they found that the disease did come back.

I asked him if this was a relatively low risk thing to try going off Herceptin, though, since there was a high likelihood that if I recurred, the Herceptin would work again. He did agree with this thinking.

He also told me of a patient he has who has BC, and had a bone met 25 years ago! treated with whatever they had at the time, driven into remission. Had a new bone met last year, and she is back in remission now. He cares so much!

So, I will have my last Herceptin in early December, and then do the scan thing again. My markers have all been normal for a long time.
__________________
Dx 8/06 Age 43 Stage IIIA multifocal throughout breast, largest tumor 5 cm, grade 3, comedo, ER+PR+HER+++
Neoadjuvant A/C 4X Dose Dense
11/06 Bilateral Mastectomy (no choice on the right, my choice on the left)
Taxol+Herceptin weekly x12, continuing with Herceptin, finished one year in 12/07
33 Rads
Femara for 5+ years, staying on (started with Arimidex, switched after about a month, much happier)
Abnormal brain MRI shows no cancer, but "extensive white matter diease" - unknown cause
BRCA negative - lots of cancer in my family
survivor of thyroid cancer
also have Crohn's disease
CT and bone scan say NED as of 5/13
dx with severe cardiomyopathy 5/12 (likely due to chemo and Herceptin), ejection fraction in low 20's, now up to 40, went to 50, latest read 12/13 is back down to 35
1/13 Acute pancreatitis - are you kidding me?
9/13 started Humira for Crohn's. starting to have some energy again
B12 and Vit D both needed supplementation
Cataracts in both eyes noted 6/12 - surgery in the next 2-4 years?
4/14 Kidney stones/blockage/infection - related to Crohn's Disease
5/14 My aunt passed away - she was diagnosed after I was with Stage I - not Her2+, then Stage 4 for about one year
6/14 Scans - still NED, thank God. However, broken rib (I didn't notice) lots of bone degeneration osteopenia/osteoporosis. I also still have cardiomyopathy secondary to chemo.
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Old 10-30-2007, 08:34 PM   #13
chrisy
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Cannon,
Good doggy! Suggest to your mommy that she request regular monitoring of Her2 serum levels - this might help her confidence level once off the Herceptin.

I can imagine it would feel like being naked and exposed, stopping the vitamin H. With the Her2 serum levels under surveillance you'll feel a little less exposed - and have an early warning system to alert you when it's time to push harder.

Glad to see you still have your fighting spirit intact. Don't ever let anyone try to take THAT away.
__________________
Chris in Scotts Valley
June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?"
9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++
10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!
04/05 - 4/07 Herception every 3 wks, Continue NED
04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial
06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin
01/08 Progression in liver
02/08 Begin (TDM1) trial
08/08 NED! It's Working! Continue on TDM1
02/09 Continue NED
02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED
12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver
07/11 - 11/11 Herceptin/Xeloda -not working:(
12/11 Begin MM302 Phase I trial - bust:(
03/12 3rd times the charm? AKT trial

5/12 Scan shows reduction! 7/12 More reduction!!!!
8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!)
9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3
11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc
11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go.
2/13 Gemzar/Carbo/Herceptin - no go.
3/13 TACE procedure
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Old 10-30-2007, 08:55 PM   #14
Bev
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Hi there,

I would guess the thing to do is wait for the spring results. As linda has said, no news likely means nothing conclusive at this point in time.

Gina, stage 4, has a different take where she has tumor markers done and asks to renew Herceptin treatment based on that periodically,

My best guess would be if your LVF has held steady, it's not a valid argument against Herceptin. Mine inproved during the course. I think Ac is the demon.

My thought is to wait for those spring studies and really scrutinize them for your particular status. The downside is they may delay the release of said studies for another year or two, which would take you to the Gina Plan B.

Hang in there. I truly believe they are going to figure this out soon. Bev
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Old 10-31-2007, 06:11 AM   #15
nitewind
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Posts: 473
I, like Donna, will be finishing my herceptin in December and I'm very worried about it. Donna, it looks like our stats are pretty much the same, the only difference is that I had no positive nodes. I know that my onc will not let me go further than one year of herceptin, I've already asked. Sometimes I wish that he was a breast specialist, but he is a general oncologist. I'm so scared about finishing the treatment, I mean, I'll be glad to have it over with but I feel that it's my security blanket. I get the H every week then every third week I see the doctor and get my blood drawn. Just makes me feel like if something was going to happen, they'd know about it early enough.
So, anyway, I'll be done in December then I'll pray for the best.
Best of luck to you, too
Hugs
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Susan
Age: 61
dx: 5/25/06
2 cm/ 0 nodes
Lumpectomy rt breast on 7/26/06
ER/PR- / Her2+++
A/C x 4
finished taxotere 2/07
finished 33 rads
Herceptin finished 12/07/07 Yippee!
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Old 10-31-2007, 12:40 PM   #16
chrisy
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Re Bev's post

Gina has been living with Stage IV for years - and managing it with herceptin only. She monitors this with the Her2 serum test (not tumor markers) and when they start to rise she goes back on herceptin. So she's on and off herceptin as necessary.
__________________
Chris in Scotts Valley
June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?"
9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++
10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!
04/05 - 4/07 Herception every 3 wks, Continue NED
04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial
06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin
01/08 Progression in liver
02/08 Begin (TDM1) trial
08/08 NED! It's Working! Continue on TDM1
02/09 Continue NED
02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED
12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver
07/11 - 11/11 Herceptin/Xeloda -not working:(
12/11 Begin MM302 Phase I trial - bust:(
03/12 3rd times the charm? AKT trial

5/12 Scan shows reduction! 7/12 More reduction!!!!
8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!)
9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3
11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc
11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go.
2/13 Gemzar/Carbo/Herceptin - no go.
3/13 TACE procedure
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