mickey... on your problem w/chemo cost etc.

mickey,

If other avenues don't pan out, I wanted to mention this: Gemzar has also been used in conjunction with Temodar in the treatment of brain mets.

Gemzar is administered by iv. So, if you could swing the cost of Temodar, perhaps your onc would consider trying the Gemzar rather than Xeloda in the combination. The molecular wght of Gemzar is actually a bit smaller than Xeloda.

Have been a bit concerned for you over this topic...so hope you can find some type of resolution for treatment options for yourself.

hugs,
pattyz

[al from Canada]

Dear Patty,
I am very nieve when it comes to brain mets. Are you saying that xeloda crosses the blood-brain barrier?
Thanks,
Al

Al,
I'm naive when it comes to ANY OTHER mets ;o) But I do get some of my very best information via the bcmets.org site.

Yes, Xeloda can cross the bbb. So can other chemos. Whether they WILL or not is dependant on a number of factors, some understood and some not yet understood. Sound familiar?? Then their is the question of responsiveness to a particular chemo, as in all cases of cancer/mets.

This is from the '04 SABCS, which I happened to discover on the bcmets.org site archives AFTER I had done some prior heavy research and was already on this combination:

SABCS ABSTRACT:
[San Antonio Breast Cancer Symposium]
[1079] Phase I study of capecitabine (C) in combination with temozolomide (T) in the treatment of patients with brain metastases from breast carcinoma.

Rivera E, Valero V, Francis D, Brewster A, Royce M, Esteva F, Murray JL, Pusztai L, Hortobagyi GN.. The University of Texas M.D. Anderson Cancer Center, Houston, TX


Background: T is an oral alkylating agent that is
currently being used for the treatment of primary
brain tumors due to its ability to cross the
blood-brain barrier. C has been approved for use in
the treatment of metastatic breast cancer patients who
have failed anthracyclines and taxanes. It is well
known that C crosses the blood-brain barrier and has
activity in the brain. Options are limited for
patients with brain metastases.

Materials and Methods: We evaluated the activity of
both drugs in combination for the treatment of brain
metastases not amenable to surgery. Patients were
allowed in the study if they had new onset brain
metastases from breast cancer, had declined radiation
therapy, and were neurologically stable. They were
also eligible if they had evidence of recurrence or
progression of brain metastases after whole brain or
stereotactic radiation therapy. C was started at 1800
mg/m2 in 2 divided doses. T was given at a starting
dose of 75 mg/m2 in one daily dose. Each drug was
given concomitantly every day for 5 days (day 1-5)
followed by 2 days of rest and restarted again for an
additional 5 days (days 8-12). Each cycle was repeated
every 21 days. We have enrolled a total of 16 pts — 6
pts at dose level 0 (C/T — 1800/75), 6 pts at dose
level 1 (C/T — 1800/100), and 4 pts at dose level 2
(C/T — 2000/100).

Results: Five pts had recurrent brain metastases and
had been previously treated with radiation therapy.
The median age is 51 yrs (range, 32-77). All pts had a
Zubrod performance status < 1. Ten pts were ER and/or
PR positive. No grade 4 toxicities have been reported.
Grade 3 toxicity includes headaches (2 pts), vomiting
(1 pt), constipation (2 pts), fatigue (2 pts),
nonneutropenic fever (1 pt). We have observed 1 CR, 1
PR, 6 MR, and 3 SD. Four pts did not respond to
treatment. One pt was not evaluable for response.
Median duration of response in brain was 10.5 weeks
(range, 6-48+ wks). Two pts with SD and 2 pts with MR
had previously received whole brain radiation therapy.
Three pts were taken off the study because of
progression of disease outside the brain including the
pt who had a CR in brain but progressed systemically.
Four pts are actively being treated in the study.
(me would equal: 2808-3120 Xeloda & 117-156 Temodar / currently on 2000 Xeloda & 250 Temodar)

Conclusions: The combination of C and T seems to be
active and well tolerated for the treatment of brain
metastases from breast carcinoma. Further studies
should include the evaluation of this combination with
radiation and as adjuvant therapy in those pts who are
at high risk of developing brain metastases.

Wednesday, December 8, 2004 4:30 PM

Poster Session: Treatment: Chemotherapy -- New Drugs and Formulations (4:30 PM-7:00 PM)


Al, if you want more of this kind of verification, let me know.

Keeping Linda and you in thought and prayer,
pattyz

[mickey]

Patty. I will talk to mt onc about Gemzar.Thank you so much for your help about the cost of these new meds. I went to the pharmacy expecting to have my credit card charged for $20 or $30. I had NO idea it could be $3000 with insurance. I have a home, but I also children. It is so difficult. I have been trying to get help and am not succeeding. If it weren't for he medical bills, I could make it. Now I am going to just keep going but will not be sad if I die because this is taking the food out of my kids mouths.

Mickey

[Sheila]

Mickey
Please go to your state legislature on this...you need this medication and your kids need you! Please email me if I can help in any way....I will do whatever I can.
It is a sad day when people cannot get treatment to save their lives due to cost and insurance issues....this is America isn't it???
Please let me know how I can help.