Chemo for Bone Mets

I just want to ask anyone with Stage IV BC who is Her2+++ Er/Pr- , with mets to the bones - what chemo combination are you taking?

I have an aggressive tumor that has proven to be resistant to AC, Taxol/Carbo/Herceptin, and Navelbine/Herceptine. The lesions continue to grow in size and intensity.
I am trying my best to stay positive but this is one of those low points when I fear I might not see my little girl grow up.
Anyone with the same type of tumor, and what chemo worked for you?

Thanks,
Anna

Dear Anna,
The lesions you refer to, depending on the number, you can use focal or external beam rads to (hopefully) eridicate them. I assume you have been on bisphosphonates such as Aredia and Zometa.
I found an article on the net which talks about Radiopharmacueticals which might be appropriate in your case:

Radiopharmaceuticals: Radiopharmaceuticals are radioactive substances that are used to treat bone pain caused by metastatic cancer. They are injected into a vein and settle in bone areas that contain cancer. Strontium 89 (Metastron) is the radiopharmaceutical most commonly used for bone metastasis. It settles in bone because it closely resembles calcium. Other radiopharmaceuticals have also been studied. These contain radioactive atoms such as samarium 153, rhenium 186, and rhenium 188. These radioactive atoms are bound to chemicals that attach to bone.

The radiation given off by the radiopharmaceutical kills the cancer cells and relieves the pain caused by bone metastases. If cancer has spread to many bones, this approach is much better than trying to aim external beam radiation at each affected bone. In some cases, the radiopharmaceutical is used together with external beam radiation aimed at the most painful bone metastases. Radiopharmaceuticals have helped many men with prostate cancer, but it is less often used for other cancers.

My other thought is that "mets are mets", regardless of the location. What about Gemzar or Xeloda + herceptin? Another very effective drug is abraxane, a type of taxol, but if you have taxol resistance this may not work either.

In any case, I wouldn't put all my eggs in one basket; use an aggressive, muti-targetting approach: Chemotherapy ( two types such as doxetaxel + xeloda)+ Biological therapy (herceptin) + biphosphonates (aredia) + rads (external and/or Radiopharmaceuticals).
Here are some links to articles on bone mets and therapy:

http://www.docguide.com/news/content.nsf/n...5256F9D0055D4C5
http://www.docguide.com/news/content.nsf/n...5256F82004D8246

Please let us know how you are making out or if you need more help in your research.
Good luck,
Al

[Isabelle]

Dear Anna,

Ask about other Herceptin/chemo. combonations. Herceptin seems to work well synergistically with other drugs. There are many out there. Herceptin and a taxane? I assume you are getting Zometa monthly for your bones. That worked well to heal my numerous small bone lesions and the weekly combo. of herceptin and navelbine stablized my mets in lung and liver.

Is your only met in a bone? That gives you a better prognosis than many of us here. You will be there for your girls!

If you are in a lot of pain from the bone met, I have heard they do radiation on the spot. BUT, I have also heard that is very hard on your immunity. I guess it kills your bone morrow or something and this could make it difficult for you to get more chemos. down the line if your cancer progresses elsewhere.

From one mother to another, wishing you years and years and years to nurture those kids,
Isabelle

[Isabelle]

Anna,

I was just on breastcancer.org and they now have a better metastaic section that seemed to go over all the treatment options, going over pros and cons and references to all the San Antonion Conferences where study info. was presented.

You may want to check out that easy to understand resource while making treatment decisions.


breastcancer.org

Isablle

Anna --

I just posted about my worries about bone mets, then I saw your post. I am er+pr- & her2+ also with bone mets. My mets seem to be very agressive too. I did AC, then taxol for the initial chemo when diagnosed. Then when the mets hit I did 6 months of taxotere -- it fought back the mets, but didn't push them back completely. I just finished 1 yr on Navelbine - again it pushed them back but I didn't acheive NED. Now I'm on herceptin/zometa only, but don't know how long till I'll have to be on a different chemo. I don't know what chemo is next for me and I worry about running through all the chemo options... and then what? Hope for more options on the horizon. My bone mets are rather limited to one area: a couple vertabrae and a couple of ribs. Where are your bone mets? How long have you been dealing with bone mets? I worry too about being here for my kids. I pray for you, me, and all of us that we can stay strong, fight with everything we've got, and find the chemos & other treatments that will give us years and years to enjoy our children. Take care. Pam

Hi,

I just visited the Sloan-Kettering Website and they have many new drug trials going on if you are interested. You can ask your onc about the following compounds:
Epothilone (BMS0247550)
KOS-953
OSI-774
all these can be combined with Herceptin. Their contact was Dr.Monica Fernier
212-639-5240.

Good Luck.

Thank you for all your input and information and concern. You all have been very helpful. I am taking note of all the info and will ask my onc on my next appointment. My onc says that gemzar or xeloda will probably be considered next. She says something about the bone scan MAY NOT be as accurate as a petscan, due to the effect of Zometa??? I'm not so sure, but I'll trust her word on that. For now, she wants me to stay on Navelbine (I'm on it since Nov) til the next petscan in 8 weeks.

Pam, I have Bone mets since Nov. Discovered 2 weeks after I finished chemo. I started with Stage 3 last year, then had a local recurrence while on AC, switched to Carbo/Taxol/Herceptin, only to discover bone mets after that. It has been a long, difficult road.
But here's to keeping the faith alive. Thanks again.

Anna, I was stage 3, too, before recurring to supraclavicular nodes & one brain met. Would you mind telling me where your local recurrence was located? Praying that you will be having the next successful treatment plan for your bone mets. Take good care ~ JO.

Anna -
Why do you think the navelbine isn't working? If your doc wants you to stay on it until the next PET scan she must have reason to believe it to be working. I was on navelbine/herceptin for 1 year. It did work at keeping the cancer from spreading. My doc doesn't do the bone scans anymore (I'm not sure exactly why) he prefers I have the PET scan - and now we have scanner that has a PET/CT all in one. I have been treated for bone met for over 2 years now. I agree it's a difficult daily road, one that we'll keep doing for our selves and our children's. How old is your daughter? I'd like to talk to you more. Please stay in touch with how you are doing and what your next scans show. Take care. Pam

Hi Jo,
My local recurrence was a small nodule just above my scar from the mastectomy. We were hoping it was some scarred tissue, but a biopsy revealed it wasn't. Plus 2 more small nodules appeared slightly above that one.
Now I have bone mets in the skull, ribs, sternum and pelvis.
I hope we survive this for a long, long time.
Anna

Hi Pam,
My onc has reason to believe that Petscan is more accurate and that the Zometa might have messed up the bone scan results. She says the good side is there are no new sites. And to stay on Navelbine for another 2 mos. til my Petscan won't make a difference. She says bones take longer to re-build.
My daughter's 2 1/2. How old are your kids?
It somehow makes this road bearable when I know I'm not alone in this fight and that I have a reason to keep fighting.

Anna
mike_n_anne2001@yahoo.com

Anna -- Yes! Knowing that others are here for us supporting us does make a huge difference - Especially people what are walking the same road (not that I wish this on anyone, of course).

Another thing about PET scan -- maybe true for bone scan too. My onc. always wants me to be a week - 10 days away from the last treatment before a PET scan so the chemo effects don't "cloud" the scan. This applies also if you take neupogen shots which I did while on navelbine to help my white blood counts. So, I'd also not do that for at least a week before the scan.

My kids are older than yours - 25 & 28. I'm 53. I am in a much different place than you in parenting. But being a mother never stops!
Pam
ppaulson@bethlehem-church.org