HER2+ neoadjuvant options

brandysands

I had my first appointment with the Breast Clinic today, but I won't meet with the surgeon and MO until 2/10.

My dr. believes that I will be doing 2-3 mos. of Herceptin before surgery. She's not sure about which chemo may be used as that is up to the MO.

Good news from today - US showed no signs of cancer in the lymph nodes.

Tomorrow I will have a breast MRI to determine how close the mass is to the chest wall and double check the nodes.

If the nodes are negative, would I be a candidate for Perjeta as well? What types of chemo are typically used for ER/PR -, HER2+, grade 3, 2.4 cm?

SpecialK

Perjeta is currently approved neoadjuvently for Her2+ tumors larger than 2cm, or node positive - but you don't need both, so you would qualify for use with a greater than 2cm mass even if your nodes are negative.  The FDA approval for early stage neoadjuvent use of Perjeta is with Taxotere and Carboplatin.  Carboplatin is also used for TNBC, so it sounds like it could be a good regimen for ER-/Her2+.  There are a couple of threads for TCHP on this site, there may be some ER/PR- peeps there, you may find use of other regimens among the people who post there - here are some links:

https://community.breastcancer.org/forum/80/topics/823947?page=23#post_4624895

https://community.breastcancer.org/forum/69/topics/828404?page=13#post_4607280

This is a ER/PR-, Her2+ thread:

https://community.breastcancer.org/forum/80/topics/767013?page=45#post_4623675

DaisyQ

Hi Brandy,

Sorry that you find yourself here, but this is a great place to find help and reliable information.

I was ER/PR-, HER2+, grade 3, 2cm. Pathology found a small cluster of cells in my sentinel node (less than .5mm). It was too small to be seen on ultrasound or MRI, and because it was so small it didn't change my stage from IIA. I had TCHP chemo: Taxotere, Carboplatin, Heceptin, and Perjeta every 3 weeks for 6 cycles then Herceptin every three weeks for a year. I did have a bilateral mastectomy about 2 weeks after my final TCHP chemo. Then six weeks of radiation once I recovered from the mastectomy surgery.

I saw my MO and BS on the same day. I had SNB and port installation surgery about 5 days later and started chemo the day after that. It seemed fast, but I was happy to start kicking some HER2 butt!

Let me know if you have any questions. I am here to help!

Amy

Italychick

I got Taxotere, carboplatin and Herceptin, no perjeta, but some women on the March 2015 chemoforum with small tumors less than 2 cm, no nodes, got perjeta as adjuvant treatment, not sure what made the difference.

rainnyc

I got Taxol, Herceptin, and Perjeta on a neoadjuvant basis, so there's some flexibility in what they can approve. The pathology report following the surgery found no evidence of disease.

Good luck to you!

Skittlegirl

I just finished 6 rounds (3 weeks each) of neoadjuvant TCHP. I had 2 tumors, the largest being 2.9cm plus a positive lymph node.

JCS28

I had Herceptin and Perjeta together before surgery with no other chemo. I was supposed to have 4 rounds but ended up with 6 rounds because of surgery scheduling and holidays. I had basically ZERO side effects. And it completely shrunk my tumor! My tumor was between 1.5 and 2 cm and I had no node involvement that they could see before surgery. I was in a special study that allowed me to have both these drugs before surgery. Then at surgery there was nothing left and no involved lymph nodes. Now I am doing 6 rounds of Taxotere along with Herceptin and Perjeta and then hopefully I'll be done. I think this is the way treatment for HER2+ is heading with possibly no bad chemo in the years to come but we're not there yet. I'm looking at these 6 rounds of Taxotere as "insurance" chemo. Good luck!

June15

Withering away - help please

Hi there,

I have stage 2a BC and post my bi-lat mast. I just finished 4 rounds of AC and then 12 weekly doses of taxol in combination with herceptin and perjeta. This last combination of taxol herceptin and perjeta has really taken a toll on my body I can barely eat and have lost soon much weight! I have had chronic diareah and the oncologist wants to continue with herceptin and perjeta every 3 weeks for a year. I am fearful that I will never be able to eat again as I am so weak. Please let me know if anyone else out there has gone through this and will I ever heal and eat before I disappear I am a petite Person to begin with and there is not much left. I just need to know if anyone else has had any issues,

Thx

ElaineTherese

June15,

I also had diarrhea when on the Taxol/Herceptin/Perjeta combo. For me, it was the Taxol. Once I stopped the Taxol, the diarrhea stopped. Hope that does it for you, too!

Dianne92

I am receiving perjeta, Herceptin, Taxol, and Carboplatin every three weeks for a total of 6 infusions. I had my first treatment in January and am due for the second treatment this week. I am struggling with stomach and digestive issues as well. I have been taking Prilosec to help with my stomach and have been eating a very bland diet-living on crackers and water if needed!! The diarrhea comes and goes-it all depends on what I eat.

I am really struggling with a lack of energy-I feel I need to rest often through the day and it is hard when I am at work.

Moderators

Dianne92, we are sorry for what you are going through with the fatigue! It is very difficult.

You may find some helpful tips a the bottom of this page: Managing fatigue

We are happy that you found us here.