treatments

valleygirl · 07-09-2021, 05:37 PM

Thank you for all the information! Once Herceptin and Perjeta stopped working I did 2 trials #1 Keytruda & TDM1, got 18 months #2 HER2CLIMB was on this over 2 years'
Currently on Enhertu, after only 3 treatments I don't think I can continue. I found it to be so debiliitating. I'm so weak I'm not able to take care of myself. I'm going to UPENN and they want me to stay on it, but I've already fallen 4 times and feel like I need someone with me at all times. I plan to start looking for a new doctor and hopefully could save Enhertu as a last resort.

Nguyen · 07-10-2021, 08:55 PM

You are correct Paul, the CDK 4/6 inhibitors are not approved for Her2+, but case for abemaciclib can be made depending on oncologist persuasion skill. We have been on it since 7/2020, unfortunately one more big jump in marker and we will have to rescan and decide in the next treatment.

About raloxifene, I believe it is approved to reduce BC risk but not to treat. I mentioned raloxifene-tamoxifen and letrozole-anastrozole (in particular) pair from the stand point that when there are two similar (mechanism of action) drugs, only one will be used and the “other one” will not be used after the tumor develops resistance to the “first one”. However in desperate situation, if one takes a very deep research to understand the “minor” differences between the two, and with luck find another class of drug that acts synergistically (perhaps reverse the “resistance pathway”) wise, then it worth a try of the “other one”, particularly if there is significant time past from usage of the “first one”. This is the case with anastrozole/letrozole and eribulin. Of course there is no clinical trial for this. It also depends on how much effort the patient’s advocate pour into the research and the oncologist’s willingness to listen. They usually do if info come from medical journals and are presented concisely.

I think it’s great that you are able to spend some of your retirement time to help people on the board. You already did your tour of duty.

Nguyen · 07-10-2021, 08:56 PM

Valleygirl, I am perplexed that you had Keytruda. I thought it’s for triple negative only. Is there any indication that Enhertu is working for you? If yes, perhaps a reduction in dosage is a possibility? We have to do this dosage reduction trial/error with each new regimen. Usually maximum (base on weight) dosage is used. But weight could not take into account that each person metabolize/absorb drug differently.

Regardless of regimen, I hope your circumstance allows you to take long nap, and try to keep up with eating healthy and exercise as best as possible.

Best wishes.