HonCode

Go Back   HER2 Support Group Forums > her2group
Register Gallery FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools Display Modes
Old 07-07-2021, 01:48 PM   #1
valleygirl
Senior Member
 
Join Date: Jan 2012
Location: Millsboro, Delaware
Posts: 140
treatments

Where can I find I list of all treatments for HER2+++
Looking for tageted therapies and chemos.

Thank you!!!!!
__________________
valleygirl is offline   Reply With Quote
Old 07-08-2021, 03:51 PM   #2
valleygirl
Senior Member
 
Join Date: Jan 2012
Location: Millsboro, Delaware
Posts: 140
Re: treatments

or maybe any treatments you been on and i can start making a list. I feel like I'm running out of options and could use some help. I hoping there are more maintenance drugs that I don't know about. My doctor isn't much help. Thank you for your help!!!
__________________
valleygirl is offline   Reply With Quote
Old 07-09-2021, 09:25 AM   #3
Nguyen
Senior Member
 
Join Date: Nov 2005
Posts: 531
Re: treatments

Perhaps you should list your treatment history and tumor’s pathology. I recommend thread titled “Current and Future Management of Her2 Positive Metastatic Breast Cancer” (diplomatically get your oncologist to read this article if he/she is not up-to-date). In “Letter to a friend …” thread I listed my wife’s treatment history. Both are in section “Articles of interest”. Also, most members have their treatment histories as part of their signatures. Anyway here is the list from memory, therefore incomplete.

Endocrine (or hormonal): tamoxifen, raloxifene, letrozole, anastrozole, exemestance, faslodex, Everolimus,

Chemo: taxane family (taxol, taxotere, docetaxol, paclitaxol, nab-paclitaxol), vinca alkaloid family (navelbine, vinorelbine), 5-FU, capecitabine/xeloda, gemcitabine, anthracyclines family, eribulin, ixabepilone, I am sure there are a couple more.

Her2-targeted: trastuzumab, lapatinib, t-dm1, enhertu, margetuximab, pertuzumab, syd-985 (still in phase-3 trial), ZW-15 phase 2.

TKI inhibitors: tucatinib, neratinib, pyrotinib,

CDK 4/6 inhibitors: abemaciclib, palbociclib, ribociclib

PIK3 inhibitors: alpelisib, there are a few more in P1/P2 trials.

Immune check point inhibitors: atezolizumab, pembrolizumab. These are approved for triple negative bc, but remember bc is extremely heterogenous. If your tumour biology is highly positive for PD-L1 and there are CD8 T-cells in your tumour cluster, and you run out of options, perhaps your oncologist (need to be very up-to-date) can do something with these drugs in combination with others.

Some info that I glim from reading: a drug can be reused if there had been multiple years (can’t remember how long) since its last used. Most (perhaps all) drugs will change the tumor’s biology particularly if it has been used for long period. With two drugs with very similar mechanism of actions such as anastrozole and letrozole, usually only one is used, however if one reads closely the slight difference in their mechanism of action might enable the “unused” one to work especially in combination with another class (biologically synergistic) of drug. Metronomic chemotherapy, some chemo (or combination) is too toxic, metronomic method is the use of very low dose with short interval to exploit the angio genesis effect. The goal is to slow progression hopefully long enough for new treatment. If one runs out of option then perhaps discuss ideas in this paragraph with your oncologist.

If it’s been a while and particularly if the tumor suddenly progress very fast or to another organ/site, seriously discuss with your oncologist to re-biopsy to get the latest pathology information to guide treatment.

IF ANYONE RECOGNIZES ANY INACCURATE INFORMATION FROM ABOVE PLEASE CORRECT ME ASAP! THANKS.

Nguyen
Nguyen is offline   Reply With Quote
Old 07-09-2021, 01:34 PM   #4
donocco
Senior Member
 
Join Date: Oct 2013
Posts: 474
Re: treatments

Nguyen

You did excelletly. its hard to believe you have no training because you know this wll and are a good source of information. As far as mistakes go I dont see any except one possible one. For some reason as far as I know, the CDK 46 inhibitors are not approved for Her 2 Neu positive cancers. please correct me if Im wrong.

I was interested in what you said about Raloxifine (Evista). It works very much like Tamoxifen except for one very positive ting. There is little or no risk of uterine cancer with Evista as it has no proestrogenic effects on the uterus wheas Tamoxifen has. Despite this as far as I know the FDA approval for Evista is only for Osteoporosis and the insurance companies hide behind FDA approval. If the approval for Raloxifene includes breast cancer Id love to know about this. It makes sense. Ive been retired for 9 years now and dont keep us as well as I should.

Paul

Please forgive any mispellings
donocco is offline   Reply With Quote
Old 07-09-2021, 05:37 PM   #5
valleygirl
Senior Member
 
Join Date: Jan 2012
Location: Millsboro, Delaware
Posts: 140
Re: treatments

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.
__________________
valleygirl is offline   Reply With Quote
Old 07-10-2021, 08:55 PM   #6
Nguyen
Senior Member
 
Join Date: Nov 2005
Posts: 531
Re: treatments

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 is offline   Reply With Quote
Old 07-10-2021, 08:56 PM   #7
Nguyen
Senior Member
 
Join Date: Nov 2005
Posts: 531
Re: treatments

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.
Nguyen is offline   Reply With Quote
Old 07-11-2021, 06:34 PM   #8
valleygirl
Senior Member
 
Join Date: Jan 2012
Location: Millsboro, Delaware
Posts: 140
Re: treatments

It was a Merck study at Dana Farber, I think I have the PDL1 mutation.
II'm currently on the lowest dose of Enhertu and every 4 weeks.
Thank you!!!
__________________
valleygirl is offline   Reply With Quote
Old 07-11-2021, 11:56 PM   #9
donocco
Senior Member
 
Join Date: Oct 2013
Posts: 474
Re: treatments

Valleygiirl

Im going to mention one thing and its a long shot. Im only going tomention what it is titled for now there will be no long explanation. Please look up dr Li nda vahdut and the ammonium tetrathiomolybdat copper reduction method of treating cancer. The drug companies and FDA would frown on this but it is quite scie tific and logical and far from quackery. Look this up if you want and see wats what. Finding someone who will do it even if you are interested may be difficult now. Pressure was put on Dr Vahdut (I believe) and as far as I know now she says little about it. The info I read about her was not about TM copper rduction but a drug recently approved for triple negative breast cancer called Trodelvy. Not that effective aand loaded with toxicity. Im a pharmacist. If I could prescribe drugs ad do lab tests I would prescribe the Tetrathiomolybdate capsules for you. But I cant. They let nurse practitioners and PAs prescribe. They can do lab tests. You have to be monitored for anemia Perhaps you could find an idealistic one. Just a suggestion. Forgive any misspellings.

Paul
donocco is offline   Reply With Quote
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump


All times are GMT -7. The time now is 07:19 AM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2024, vBulletin Solutions, Inc.
Copyright HER2 Support Group 2007 - 2021
free webpage hit counter