Gemzar tough on WBC/platelets

I had my first Gemzar/Herceptin treatment 3 weeks ago. My wbc went so low, no Gemzar the next week. Then last week, a full dose of both. This week, again my white count was extremely low; my platelet count was almost too low. Since today was Herceptin only anyway, we didn't have to worry about Gemzar.

But it sounds as though I'm only going to be able to tolerate it every other week. My onc has not yet recommended Neulasta this time; not sure why. I suppose he doesn't want to mess with the bone marrow any more than we can help.

As far as side effects, I had slight headaches and slight to moderate nausea the week following the treatment. Typical?

The GOOD news is that my thoracic MRI showed that the highlighted met on my spine is not impinging on the epidural canal. We'll just have to watch it closely. Thoughts of our friend, Mary, automatically come to mind.

Love and light,

Lisa

Sorry, I do not have answers to your questions, since I have never had Gemzar. But I do have a question! :-)

Here goes: can Gemzar be adjusted, just like Xeloda, or altered its schedule, like 2 weeks on & 2 weeks off, or weekly, tri-weekly? Just wondering if Gemzar can be adjusted, would the new change make your side effects easier on your body?

Lisa

You should ask your onco about Leukine shots (or Neulasta). I used Leukine instead of Neulasta with the dense dosing regiment. I was lucky that my onco would let me use it. Both are WBC boosters but Neulasta only boosts the neutrophils. Leukine boosts all WBC components including the cancer killing monocytes (macrophages) and dendrites (the scouts that alert the killer T cells). Leukine is used in the vaccine trials because it boosts the total immune response.

The only pitfall with Leukine is that it is not sustained release as Neulasta is. Therefore you need to get 10 shots for 10 days in a row starting 24 hours after chemotherapy. Neulasta lasts 10 days in the body because the active is "pegalated" (polyethylene glycol is coated around the active. The active still works but the body does not recognize it as non-self and does not destroy it as readily so it "lasts" - hence Neu (for neutrophils) and lasta (for lasting effect)). Leukine has known anti-tumor and cancer killing effects.

Ask - you have nothing to lose and may be able to get Gemzar on time and get some immune killing effects of Leukine (for the record, Berlex Labs is working on a pegalated version of Leukine but it is in testing and not FDA approved yet. You can read more about Leukine and all its effects on www.leukine.com)

Best wishes

Becky

Lisa,
I had a clinical trial of Gemzar/Herceptin for 9 months. On day one, I had Gemzar and Herceptin both, then day 8 was Gemzar only, and day 15 was nothing. I had slightly low red cells a couple of times, and received Aranespt in my IV. My platelets were fine the whole time.
I guess I was really lucky. I had also read about drinking red grape juice during treatment to help with the platelets and reds. I also ate real white limas (the kind you have to cook for a couple of hours), supposedly to help my white cells.
My only side effects were thinning hair, and some nausea the evening of treatment.
When I started the trial, my liver had a 9cm tumor plus numerous 2 cm tumors throughout. After 9 months, my liver showed NED, and it has remained thus for 10 months (I am getting a CT scan today).
Good luck!
Denise in PA

[StephN]

Good News about your spine area!

I really would like to see you be able to get the drugs you need in the effective amounts. Without a "get tough" approach, bringing all the help you need to the situation, you may stumble along some more and this is not the way to beat these mets.

What good is being less hard on the bone marrow, if you can't get free of the chemo one of these months?? My bone marrow bounced back and I had Neupogen for 7 months running at one point. Without it I never would have stayed on treatment and make it to NED. (Neulasta and Leukine were not then avail.)