Herceptine and Alimta

[Helle]

Dear everyone.

I am 40 years and I live in Denmark
I have lived with stage 4 bc for now 8 1/2 years. Treated with Herceptine alone and in combination with all the normal cemo. Right now in combination with Gemzar for over half a year. My onc. next idea is to try a new drug in Denmark, Alimta. I was vundering if any of you have infomations about the drug and if it is able to be given in combination with Herceptine. I can´t find any informations on that.

Thank you and take care all of you

Helle

[mts]

Is your doc switching you off Gemzar for the Alimta? I though Alimta was for asbestos induced lung cancer... I know some drugs work better than others- but why Alimta for bc?

maria

[Helle]

Dear Maria.

Yes Alimta is for lung cancer. I don´t think my Gemzar will continue to help me more, because I can fell it is time to change cemo. There is no more cemo used for bc left for me to try, thats why he wants to try Alimta. If you have any other ideas please let med know.

Helle

[mts]

Hi Helle,

Go to the Search button on the top of this web page and type alimta. You will see many threads from previous women who have had lung mets and they all talk about their treatments.
Generally, if you have a question, you can find some helpful info here.

Best to you-
Maria

[StephN]

Dear Helle -
I am assuming that you have stubborn lung mets and that is the reason your doctor is interested in trying the Alimta.
Please comfirm which place the mets are that need treating.

You have done and AMAZING job of surviving for so many years!
Congratulations for that.

I was on Alimta and herceptin after Gemzar stopped working. I was on it for 2 months but it did not work for me. That doesn't mean it won't work for you. I found it easier to take than the gemzar but I think you have to have vitamin B12 before you take it and while you are on it. I can't remember for sure but I am sure it was a B vitamin otherwise you get very anemic.

I think it's great that your doctor is thinking about options and I wish you the best of luck.

[Helle]

Dear Steph.


Thanks for your reply and yes I have metc. in my lung. The left lung is bad and the metc are placed in the pleura. And I think thats why my onck is surgesting Alimta for me.

Take care

Helle

[Helle]

Hey.

Thanks for your reply. I was vundering if you lost your hair during Alimta?
May I ask what cemo you are having insted for Alimta.

Thanks very much

Helle

[al from Canada]

Hi Helle,

First congrats for being a survivor!

The first choice around here for lung mets is usually navelbine sometimes with or without xeloda. Have you tried this?
regards,
Al

Hi Helle

No I did not lose my hair but I was given Alimta only twice, 3 weeks apart. After Alimta stopped working, I did an experimental trial that did not work. Then I went on Doxil for 6 months and am now on another experimental drug.

Best of luck.

[Lolly]

Helle, it's great to see your post! Here's a link to a Drug List of chemo's that was put togther by some of the members here, with a LOT of help from Al. If you have trouble opening the file, let us know and maybe Al can help. I thought if you have trouble with Alimpta this would give you some other options to check on with your onc. Best wishes

http://www.her2support.org/chemo.xls

<3 Lolly

1: Semin Oncol. 2006 Feb;33(1 Suppl 2):15-8. Related Articles, Links

Clinical experience with pemetrexed in breast cancer.

Martin M.

Servicio de Oncologia Medica, Hospital Universitario San Carlos, Ciudad Universitaria, Madrid, Spain.

Alimta (pemetrexed) is a novel multitargeted antifolate that inhibits several enzymes in the de novo pathways of pyrimidine and purine biosynthesis, including thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase. Pemetrexed possesses antitumor activity in several solid tumors, including non-small cell lung cancer, malignant pleural mesothelioma, pancreas, colorectal, gastric, bladder, breast, and head and neck cancers. The main toxicities of the drug are myelosuppression, skin rash, and mucositis. Both myelosuppression and mucositis are more frequent in patients with high homocysteine plasma levels (an indicator of deficient vitamin B(12) and folate pools). Supplementation with vitamin B(12) and folic acid greatly reduces most severe toxicities and has been implemented in pemetrexed trials since December 1999. Pemetrexed has been tested in five phase II trials in locally advanced or metastatic breast cancer. The drug has shown an activity of around 30% in advanced breast cancer patients with minimal or no prior chemotherapy. In patients who received prior anthracyclines, response rates of 21% were reported. Responses have also been observed in a moderate proportion of patients who had been pretreated with anthracyclines, taxanes, and capecitabine. Some studies have suggested that a correlation exists between thymidylate synthase tumor expression with pemetrexed antitumor activity; this attractive hypothesis should be confirmed in further studies. The optimal dose when combined with vitamin supplementation is under current investigation in patients with breast cancer. A randomized phase II study comparing pemetrexed 600 and 900 mg/m(2) with vitamin supplementation as first-line treatment for metastatic breast cancer is ongoing.

PMID: 16472713 [PubMed - in process]

1: Clin Cancer Res. 2006 Feb 1;12(3):832-8. Related Articles, Links

A Phase II Trial of Pemetrexed in Advanced Breast Cancer: Clinical Response and Association with Molecular Target Expression.

Gomez HL, Santillana SL, Vallejos CS, Velarde R, Sanchez J, Wang X, Bauer NL, Hockett RD, Chen VJ, Niyikiza C, Hanauske AR.

Authors' Affiliations: Instituto de Enfermedades Neoplasicas, Lima, Peru.

PURPOSE: This phase II trial of pemetrexed explored potential correlations between treatment outcome (antitumor activity) and molecular target expression.EXPERIMENTAL DESIGN: Chemonaive patients with advanced breast cancer received up to three cycles of pemetrexed 500 mg/m(2) (10-minute i.v. infusion) on day 1 of a 21-day cycle, with folic acid and vitamin B(12) supplementation. Tumors were surgically removed after the last cycle of pemetrexed as clinically indicated. Biopsies were taken at baseline, 24 hours after infusion in cycle 1, and after cycle 3.RESULTS: Sixty-one women (median age, 46 years; range, 32-72 years) were treated and were evaluable for response. Objective response rate was 31%. Simple logistic regression suggested a potential relationship between mRNA expression of thymidylate synthase (TS) and pemetrexed response (P = 0.103). Based on threshold analysis, patients with "low" baseline TS (</=71) were more likely to respond to pemetrexed than patients with "high" baseline TS (>71). Expression of baseline dihydrofolate reductase and glycinamide ribonucleotide formyl transferase tended to be higher in responders but this association was not significant (P > 0.311). TS expression increased significantly between baseline and biopsy 2 (P = 0.004) and dropped to near baseline levels at biopsy 3. Conversely, dihydrofolate reductase and glycinamide ribonucleotide formyl transferase decreased after pemetrexed chemotherapy.CONCLUSIONS: Our results suggest a potential association between "low" pretreatment TS expression levels and response to pemetrexed chemotherapy. Future trials examining expression levels of other genes important to the folate pathway and/or breast cancer may identify a more robust multigene profile that can better predict response to this novel antifolate.

PMID: 16467096 [PubMed - in process]

[mamacze]

Hi Helle!
How nice it is to hear from such a "seasoned" warrior! It seems like you have alot of good experience to share with us!
I was diagnosed with mets to the lungs in 2004 and went on Herceptin and Navelbine. It worked well for me and I still have no evidence of disease. I have not heard of Alimta...what other drugs have you been on? Can you share with us all of the chemos you have tried and how long they lasted?
love Kim from CT
ps Lolly, thank you for resurrecting that list, it is helpful to see it again...