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Old 03-29-2012, 12:57 PM   #1
xcrunner53
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Neoadjuvant chemo + herceptin... duration of herceptin?

Hi, my mom was diagnosed last year with Her2+ breast cancer and I'm just on here trying to gather some information.

She was diagnosed on 12/21/10 with a 1.8cm tumor (HER2+/ER+/PR-). She went through 3 months of weekly chemo treatment of abraxane and herceptin. Then in June she had a bilateral mastectomy with all sampled nodes clear. Post surgery she continued on herceptin and is currently still on it.

My mom has received mixed answers from her doctors as far as the duration of her herceptin treatment. Originally she was told she would be on herceptin for 52 weeks, however the doctors did not specify whether or not this included the 12 weeks while she was on chemo prior to surgery.

For those of you who have done neoadjuvant treatment and/or are familiar with it, I am curious if you have any information that confirms that the duration of her herceptin should include the doses prior to surgery or not.

Thank you!
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Old 03-29-2012, 01:25 PM   #2
xcrunner53
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Re: Neoadjuvant chemo + herceptin... duration of herceptin?

Also just to clarify some things so you all have a better understanding of my mom's cancer and treatment...

Chemo was weekly.
She was on abraxane/carboplatin/herceptin from Feb '11 to June '11 (started with TCH but had to stop taxotere due to toxic reaction) .
Bilateral mastectomy in June '11.
Resumed perception only infusions in July '11 through March '12.
Had 2 PET scans - March and Oct '11 - both clear.
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Old 03-29-2012, 01:26 PM   #3
xcrunner53
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Re: Neoadjuvant chemo + herceptin... duration of herceptin?

Another question I have is do any of you believe that my mom should have another PET scan following her completion of herceptin?
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Old 03-30-2012, 09:10 AM   #4
Mtngrl
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Re: Neoadjuvant chemo + herceptin... duration of herceptin?

I think they generally do Herceptin for a total of one year with early stage breast cancer. As I understand it, only Stage IV goes longer than that. The 12 weeks of chemo count in the 52 weeks.
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Amy
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4/19/11 Diagnosed invasive ductal carcinoma in left breast; 2.3 cm tumor, 1 axillary lymph node, weakly ER+, HER2+++
4/29/11 CT scan shows suspicious lesions on liver and lungs
5/17/11 liver biopsy
5/24/11 liver met confirmed--Stage IV at diagnosis
5/27/11 Begin weekly Taxol & Herceptin for 3 months (standard of care at the time of my DX)
7/18/11 Switch to weekly Abraxane & Herceptin due to Taxol allergy
8/29/11 CT scan shows no new lesions & old lesions shrinking
9/27/11 Finish Abraxane. Start Herceptin every 3 weeks. Begin taking Arimidex
10/17/11--Brain MRI--No Brain mets
12/5/11 PET scan--Almost NED
5/15/12 PET scan shows progression-breast/chest/spine (one vertebra)
5/22/12 Stop taking Arimidex; stay on Herceptin
6/11/12 Started Tykerb and Herceptin on clinical trial (w/no chemo)
9/24/12 CT scan--No new mets. Everything stable.
3/11/13 CT Scan--two small new possible mets and odd looking area in left lung getting larger.
4/2/13--Biopsy of suspicious area in lower left lung. Mets to lung confirmed.
4/30/13 Begin Kadcyla/TDM-1
8/16/13 PET scan "mixed," with some areas of increased uptake, but also some definite improvement, so I'll stay on TDM-1/Kadcyla.
11/11/13 Finally get hormone receptor results from lung biopsy of 4/2/13. My cancer is no longer ER positive.
11/13/13 PET scan mixed results again. We're calling it "stable." Problems breathing on exertion.
2/18/14 PET scan shows a new lesion and newly active lymph node in chest, other progression. Bye bye TDM-1.
2/28/14 Begin Herceptin/Perjeta every 3 weeks.
6/8/14 PET "mixed," with no new lesions, and everything but lower lungs improving. My breathing is better.
8/18/14 PET "mixed" again. Upper lungs & one spine met stable, lower lungs less FDG avid, original tumor more avid, one lymph node in mediastinum more avid.
9/1/14 Begin taking Xeloda one week on, one week off. Will also stay on Herceptin and Perjeta every three weeks.
12/11/14 PET Scan--no new lesions, and everything looks better than it did.
3/20/15 PET Scan--no new lesions, but lower lung lesions larger and a bit more avid.
4/13/15 Increasing Xeloda dose to 10 days on, one week off.
7/1/15 Scan "mixed" again, but suggests continuing progression. Stop Xeloda. Substitute Abraxane every 3 weeks starting 7/13.
10/28/15 PET scan shows dramatic improvement everywhere. All lesions except lower lungs have resolved; lower lungs noticeably improved.
12/18/15 Last Abraxane. Continue on Herceptin and Perjeta alone beginning 1/8/16.
1/27/16 PET scan shows cancer is stable.
5/11/16 PET scan shows uptake in some areas that were resolved on the last two scans.
6/3/16 Begin Kadcyla and Tykerb combination
6/5 - 6/23 Horrible diarrhea from K&T together. Got pneumonia.
7/15/16 Begin Kadcyla only every 3 weeks.
9/6/16 Begin radiation therapy on right lung lesion that caused the pneumonia.
10/3/16 Last of 12 radiation treatments to right lung.
11/4/16 Huffing and puffing, low O2, high heart rate, on tiniest bit of exertion. Diagnosed as radiation pneumonitis. Treated with Prednisone.
11/11/16 PET scan shows significant improvement to radiated part of right lung BUT a bunch of new lung lesions, and the bone met is getting worse.
11/22/16 Begin Eribulin and Herceptin. H every 3 weeks. E two weeks on, one week off.
3/6/17 Scan shows progression in lungs. Bone met a little better.
3/23/17 Lung biopsy. Tumor sampled is ER-, PR+ (5%), HER2+++. Getting Herceptin and Perjeta as a maintenance treatment.
5/31/17 Port placement
6/1/17 Start Navelbine & Tykerb
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Old 03-30-2012, 12:37 PM   #5
jra40
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Re: Neoadjuvant chemo + herceptin... duration of herceptin?

Hello! I had neo-adjuvant treatment for early stage breast cancer. I am in a trial clinical trial that required me to receive Herceptin for 1 year following my first dose. My first dose was in March of 2011 and I just finished last week.

Your mom was lucky to get a PET scan - I did not get any scan at all which I am a little upset about. My oncologist said it was not necessary but I still would've liked the reassurance.

Rest of treatment protocol and results are below my signature line.

Jessica
__________________
11/17/10 - Diagnosed with 4.5cm tumor in right breast, IDC, Stage 2, Nuclear grade 2, ER+ PR+ HER2+
12/13/10 - Lymph node biopsy - negative
12/28/10 - Started neo-adjuvant treatment along with clinical trial with 4 rounds of AC chemo every 3 weeks
3/15/11 - Began weekly Taxol/Herceptin infusions along with 750mg of Tykerb taken by mouth daily
6/28/11 - Finished last cycle of Taxol
7/27/11 - Breast MRI shows tumor has dissolved, remarkable reaction to chemo
8/31/11 - Lumpectomy, Sentinel Node biopsy. Node negative, clear margins, 7mm of cancer left over from chemo.
10/05/11 - Started radiation, 5 days a week for 7 weeks.
11/8/11 - Finished radiation
3/21/12 - Last Herceptin!
3/26/12 - Port removed!
Tamoxifen for 5 years
8/4/15 - Hysterectomy & bilateral salpingo-oophorectomy. Due to large fibroids. No cancer!
8/8/15 - Started Arimidex
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