nonresponder to neaoadjuvant chemotherapy

Vildanbt

Hello my mother got 3 cycle of neoadjuvant chemotherapy for invasive micro papillary carcinoma. After 3 cycle we had an ultrasonography and there was no difference between chemo and after chemo.

Is there anyone like that?

What should we do? Switch to another drug or surgery?

I am so confused

Racy

what have your mother's doctors advised?

Kicks

She needs to discuss the options with her chemo Dr and surgeon.

No one here can tell her what to do - only Drs who actually are seeing her and her reports/scans/tests/etc. can give information that is designed for her. Definitely none of us can.

Vildanbt

We discussed with the doctor. They dont advise surgery during chemo so switched to FEC protocol and stopped Herceptin. I just wanted to know if there is anyone like that who changed the protocol

leggo

Hi Vildandt. Sorry to hear about your mom. It's not all that unusual for a certain protocol not to work. Many have been through different protocols, but I am only familiar with post-surgery scenarios. Hopefully, the FEC will work. As far as surgery is concerned, I can't speak to why surgery wouldn't be recommended if the initial protocol failed. I would certainly want a good reason. I've had several surgeries throughout chemos so I know it's possible. Granted, there's a small window, but it's certainly possible. Either way, I would absolutely question the oncologist for a better explanation as to why he's doing what he's doing. Good luck to your mom and best wishes to you both.

besa

http://www.medpagetoday.com/MeetingCoverage/SABCS/...;eun=g732838d0r

This was just presented at the San Antonio Breast Cancer Symposium - at least consider discussing with your mom's MO.

Vildanbt

Hi leggo. Doctor explained if the tumor had grown then we would stop chemo and switch to surgery. But the tumour size did not increase it is still in the same size so we should go on with another drugs. I am worried because I want best for my mom. Yes I know everything may go better or worse. I can not control everything. Sometimes I blame myself did I choose the wrong oncology doc, was 3 cycle waste of time ? I hope FAC works better.

Besa I read the article but it is about HER-. My mom is HER+.

besa

Vildanbt- I apologize. I missed the HER2+ in her diagnosis. Possibly a 2nd opinion with another MO would help you decide if you are on the right path.

leggo

Vildanbt, sorry I could not offer more info. I would hope that the oncologist knows what he's doing. I'd still ask questions though. Without really being at all familiar with your mom's diagnosis, mostly I'd want to know why the neoadjuvant chemo trumps surgery.

KBeee

I have a friend who had the same situation. They did surgery then switched to FEC chemo. I would get a 2nd opinion if it were me.

Gohan1983

Vildanbt, why your mom didn't receive taxanes? Maybe doctor should considered TCH protocol (docetaxel, carboplatin, trastuzumab). But if trastuzumab doesnt' work, adjuvant lapatinib or pertuzumab can be a good choice. Your mom should alsko receive aromatase inhibitors, not tamoxifen. I believe that's everything will be OK

Vildanbt

gohan1983

She received docetaxel but it did not work. We got a 2nd opinion. They also told adriamycin is important we should try it. We will receive 2 cycle FAC and have an USG again.

The advantage is we learned that tumour is resistant to docetaxel. This is good part of neoadjuvant. It is like in vitro test.

I sometimes afraid of progression or metastases during neoadjuvant chemotherapy but doctor said it is possible theoretically but very very rare in practice.

Gohan1983

Yes, but in fact during neoadjuvant chemotherapy in locally advanced breast cancer, micrometastases in distant organs are common. I hope anthracyclines may be more active in HER-2 positive subtypes than taxanes (Luminal B and HER-2 enriched) Mom should receive postmastectomy radiotherapy to prevent local/regional recurences, which are frequent in IMPC. Is your mom resistant to trastuzumab?

Vildanbt

The tumour shrinked from 26 to 23 mm with 2 cycle herceptin. It means it is an early nonresponder stable tumour.Tumour still have too much vascularization with Doppler. May be it is resistant to herceptin because She already received 2 cycle transtuzumab. Our hope is now adriamycin and 5FU.

Gohan1983

http://meetinglibrary.asco.org/content/119587-135

I reckon you should read this article

Vildanbt

It is hopeful article. We should read it once in a day ☺Life is full of surprises. Sometimes a person can die from influenza white another person lives for long years with cancer.

Gohan1983

It's confirmed results of many research that Luminal B ER+PR-HER-2- has the worst prognosis among all "Luminal B variants"

Vildanbt

gohan1983

How is grandma? Is She okey now ?

Gohan1983

Yes, aside from her atrial fibrilation and diabetes. She sometimes experiences shortness of breath, especially while performing physical activity more than usual (for example during long walk). It's associated with her AF. But generally, she's okay. I wish you and your mom good health and a lot of happiness

agness

perhaps this may be of help:

Strategies to overcome trastuzumab resistance in HER2-overexpressing breast cancers: focus on new data from clinical trials

http://bmcmedicine.biomedcentral.com/articles/10.1...

I guess I would try lapatinib begore abandoning all anti-HER2 therapies.

Also, you can do more as far as nutritional testing, to try to correct imbalances. Regilar docs don't look but my naturopathic oncologist had labs based on common imbalances in cancer patients -- I was way off the cgarts, but my CBC was fine.

Take a look over at the HER2Support.org forums where I have beeb posting my research.

http://her2support.org/vbulletin/forumdisplay.php?...

agness

another idea, employ water-based fasting during active chemo

Study Suggests Using Excess Stress to Kill Therapy Resistant Breast Cancer

http://www.prnewswire.com/news-releases/study-sugg...

There is some great info about fasting on the boards and this article talks about usung it with HER2. Uour focs will not suggest this, in fact they will try to dissuade you most likely. Get a FABNO naturopathic oncologist and ignore your oncology team

Vildanbt

After surgery today we got our Pathology. Tumour is 2 cm and 6 lymph nodes have metastasis. After neoadjuvant chemotherapy Pathology showed no response. Tumour has no necrosis.😯