TCH treatment for HER2

cindbo

I am positive on both, I have not heard from many women that are postive on both. I am also waiting to hear back on my TOPO 2 status. I know with positive status for either ER/PR or Her2neu there are treatments that at least slow down or block the process.

cindbo

Why not treatment of choice for ER/PR postive too?

daisybell

Cindbo
Even if you are her2+, also being ER/PR+ is not a bad thing. Are you post menopausal? I think taking an aromotase inhibitor like Arimadex has been shown to be effective when taken with herceptin. Even though I am her2+ and ER/PR- I still wish I was ER+

cindbo

There is so much out there it gets confusing. I hadn't read any references in the latest research out of San Antonio about ER/PR status in relation to HER2 status, so I was curious to read more about it. I am pre-menopausal, they expect me to go menopausal during chemo as I am 46 and was perimenopausal before dx. There is also discussion about having my ovaries removed. I am going to have the Brac1/2 testing completed to help determine that. Not sure about the uterus, guess there is some indication to remove that too. I did find a lab in Seattle that does run the TOPO2-but I did have to push to have it done. My Her2 status was done off my biopsy and it was +++3 w/ done w/ IHC, they did not re-run off my mastectomy or with FSH...should I push for that too? I imagine my oncologist will flip! I also just need to get back on my regime at this point too as waiting for the TOPO2 has me off a week (q4). Good to have a place to "freak" out about all this stuff.

daisybell

If I was ER+ I'd probably have the ovaries and uterus removed. One less place to get cancer. I think I've read something about ER/PR and her2, maybe that tamoxifin is not as effective but arimidex is? If I can find something I'll let you know.I was 3+ by IHC, but also had FISH done and was 2.4, also positive. In the hospital where I work they now do FISH on everyone.
Sue

cindbo

is it possible to be +3 her2 on IHC and come up negative on FISH?

daisybell

Yes, it is possible, but not very common. The IHC could be a false positve.
Sue

jamie33

I had AC 6 yrs ago was Trip neg. This time I am ERPR- and her2 +++. I have even questioned the error ratio on the IHC vs Fish test as this time my IHC test was 1 and FISH was 3+. I questioned if i should have my old tumor retested to see if this really is new primary or recur since my old was only tested on IHC, but then again herceptin wasn't even available to early stage BC back then. I was stage 1 and now Stage 2, both were grade 3. Same breast.
Hang tough and trust your gut!
Jamie

daisybell

FISH test results are reported with a number not 3+, the should say amplified or not amplified. IHC 1+ is negative. Are you sure you don't have it backwards.
sue

katymom

I am getting ready to start TCH for Her2+ ER+ Stage 1..I had a TOP2A (TOPO) test and am nonamplified therefore don't require Anthracyclins. I am interested to hear how others are doing on TCH as it is not the standard treatment. If anyone wants more info look up the study BCIRG006....I don't have the link but you can do a search. It compares TCH and ACTH. I am new to message boards so please bear with me....this is all new.

debic

What is the TOPO test? I am stage 1 grade 3 1.4cm er/pr+ Her2 +. I was told A/C then TH no choice. I have read all the post and don't understand ther ER/PR positive Neg making a difference.
Debi

janet11

I had the TOPO2 test too and went through 6 cycles of TCH as a result. I don't think the test is accepted by many because it's relatively new and doesn't have a lot of test results. BUT, for some of us, it's one way to decide which treatment is best.

I finished my last cycle of TCH in mid January 2007. It's VERY doable.... my main problems were the taste bud changes, but thank goodness those were gradual. But I lost my taste for coffee and chocolate within the first cycle (*laugh*).

Good luck,
Janet

katymom

The Topo Test (also called Top2A) further tests Chromosome17 where Her2 shows up. If Top2a defines an amplification then you need the anthracyline to treat. If it is not amplified then TCH (Taxotere, carboplatin, and herceptin) may be as affective without some of the major side effects. This is all based on the BCIRG0006 study that is ongoing. My oncologist is recommending no anthracyclines for me at this time.

Chelee

I was DX last year and was given no choice or say so in my chemo trt. I was told I would be doing TCH...which I did. But now I wonder about what your saying here. They did not have the Top2A when I was DX to my knowledge? I think I heard about that around the time I finished my chemo.

But I did have a FISH test and I am her2/neu 3+++. And it says its amplified 4.4. So does that mean since MINE WAS amplified the TCH was NOT a good choice for me and they should of never even considered it and went with the AC followed by TH?

Chelee

janet11

Chelee, the topo2 test is still "experimental". I'm one of the few people who had it last year and went through 6 cycles of TCH as a result. But now since TCH is being proven to be just about as effective as AC with fewer serious side effects, more and more people are showing up on these boards who are getting TCH without the topo2 test.

Janet

pnpmary

I asked my oncologist today about the TOPO2 test. She was just at a conference two weeks ago where it was stated the the original research did not hold regarding predicting who needed adriamycin. I was going to push for the test myself as I have concerns re AC-TH. However both the oncologists I've seen are too cautious given my age and my tumor grade to recommend TCH.

pnpmary

age 42 3.5 cm node negative HER2+ ER/PR- tumor grade III

janet11

That's what I've been reading too, that the TOPO II results didn't hold up later. My doctor and I DID know that the TOPO II test wasn't proven...

DurhamGirl

Hi everyone! I know I am late to this group, and I might be repeating what people said before...but I went for my chemo infusion yesterday (#4 of 6 TCHP cycles). The MO had just returned from a big oncology conference in San Antonio and reported that the latest research on carboplatin (the C of that regimen) shows that it is not really very effective at all for HER2+ women, given that Herceptin and Perjeta are so effective now. Additionally, the carboplatin is very toxic with troubling side effects for many women.

I have been experiencing tinnitus and some hearing loss since my second treatment that I am pretty sure is related to the carboplatin. I didn't feel like the oncologist was taking my concerns about the hearing issue seriously, so I arranged a hearing test with an audiologist a few weeks ago, and they did indeed find some (minor but concerning, at least to me) hearing loss in one ear. And the audiologist explained that the tinnitus is likely my brain trying to compensate for that hearing loss. It's not clear whether these issues will be temporary or permanent for me.

Anyway, my MO decided to stop the carboplatin for me and for all of her other HER2+ patients who are also getting antibody treatments (if they agree, that is). I mention this because if you are HER2+ and are getting carboplatin as part of your chemo regimen, it might be worth a discussion with your MO about whether the carbo is worthwhile.