Confused...

Ang7

Hi,

I am a bit confused about HER+.  Is the chemotherapy treatment combined with herceptin important or is it more the herceptin?  I know not many doctors will do herceptin by itself, but could you use a less harsh chemo. treatment with the herceptin and still get possible good recovery results?

Thanks,

Ang

nagem

My understanding is that it really depends on the characteristics of your tumor and whether you have positive lymph nodes. If you have an aggressive cancer with positive lymph nodes, the tendency is to use a harsher chemo in combination with herceptin, whereas if your cancer is earlier and less aggressive, a milder chemo may be prescribed. More and more, the trend is toward customizing treatment to your specific situation. Good luck, Ang.

mmm5

It will depend on your stage and your Onc.

Most agree and there is some data that show that chemo given at same time as Herceptin is most effective. I don't think there is any data yet that shows Herceptin alone is as effective as with chemo.

There are many regimens out there ACTH TCH and now a popular way to go is TAXOL/Herceptin especially for early stage Her2. It is important to have an echo or Muga scan prior to treatment to monitor your heart/EF. You may want to ask questions about the impact of ACTH on the heart vs. TCH has been shown that it has less cardiac toxicity.

Once you have your full staging and path report let us know and we can share our journeys as well.

Ditasea

Chemo certainly helps, and the type of chemo given depends on other aspects of your tumour, as already posted. FEC is better with ER+, where taxotere (as, for ex in TCH) is less efficient, but FEC is 22 times more expensive than TCH, so it is seldom used in U.S, though it is very common in Europe. 

Ask your onc about the possibility of your going on FEC if you are ER+. 

mmm5

I was told my 2 Oncs' that FEC is ineffective for HER2 of course that is what the Herceptin is for. The Taxanes are supposed to be the most effective for grade 3 HER2 tumors. Now I don't have a study for that this is just what 2 ONCS relayed to me.

orange1

I agree with mmm5.  I have seen a study that demonstrated that taxanes are especially active in Her2+ tumors.  As usual, if anyone would like a copy please pm me with your private email address (so I can attach a file when I reply).

bluedasher

The combination of Herceptin plus chemo has been shown to be more effective than either alone. You can use a less harsh chemo. For example, BCIRG 006 tested AC-T, AC-TH and TCH. The last was as effective as AC-TH but by removing Adriamycin the effect on the heart was less and other side effects were less. For stage I there is a trial now that is using just Taxol (or maybe Taxotere, I don't remember exactly which) and Herceptin.