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Old 12-24-2009, 11:15 PM   #1
Chelee
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Loading dose of herceptin when it was not
When I was told I had a recurrence in Sept. I had my 1st loading dose of herceptin then. Due to my femur surgery I planned it out so as to not to interrupt my herceptin infusions at all. I got it on schedule and never missed a dose.

Well some how my onc wasn't paying enough attention and I now find out that I got another loading dose of herceptin when I first started up the Navelbine wks ago. For some reason when I went to City of Hope and spent the 5 days in the hospital due to the hip surgery...she thought I was off schedule and missed my herceptin. (But I didn't!) So she wrote orders for my chemo nurse to give me "another" loading dose of herceptin when she first started me on Navy Beans.

I've tried telling my onc two or three times now I was NOT due a loading dose...I never missed my herceptin. (This issue has come up for 3 weeks now at each of my appts.) Well she finally got it through her head at my last visit and said that it doesn't matter and it won't hurt me. (How does she know that for certain?!) Although minor...I call it a over dose since I wasn't due to get that much herceptin. I seem fine...but I can't believe my onc is that scattered.

How much difference is there in the loading dose and the regular maintenance dose? Anyone know?

Chelee
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DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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Old 12-24-2009, 11:22 PM   #2
Rich66
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Re: Loading dose of herceptin when it was not
Recent findings suggest that higher doses of Herceptin may be beneficial to higher her2 positivity patients. Considering this (a trend toward higher dosage), and the cost of the drug, I suspect you got a bit of a bonus dose. Yayyy! Much better than getting a suboptimal loading dose. Boo.
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Old 12-25-2009, 10:35 AM   #3
Becky
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Re: Loading dose of herceptin when it was not
For the weekly regime, the loading dose is twice as much. for the every 3 wks - its 25% more. I think weekly is 2mg/kg body weight (load is 4mg/kg). Every 3 weeks is 6mg/kg and load is 8mg/kg.

It won't hurt you to get more.
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Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 12-25-2009, 04:17 PM   #4
Hopeful
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Re: Loading dose of herceptin when it was not
Hi Chelee,

Rich is correct - see this abstract from the most recent SABCS: http://her2support.org/vbulletin/sho...eferrerid=1173

Hopeful
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Old 12-25-2009, 07:15 PM   #5
Chelee
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Re: Loading dose of herceptin when it was not
It seems I may have actually benefited from my onc's error for a change. It's about time. Thanks to all three of you...much appreciated.

Chelee
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DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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