Ibrance

Tychad

hi hope everyone is doing well. I’ve just started my 3 cycle of Ibrance. Before I started my cancer markers was 106. Just had blood work and now it’s 109. I thought it would of came down. Does this mean that Ibrance is not working. If so what pill is next to try. Worried. Thank yo

EV11

Tychad-- Please don't worry-- those 2 values are almost identical--I am in the middle of cycle 35 of Ibrance/letrozole and have had little (and sometimes 1 or 2 months of >20% increase) fluctuations month to month over the past 2 1/2 years. When I first started this treatment my onc said something like this about tumor markers: The lab allows 10% variation within test results, so any test that changes by 10% or less (either in the 'positive' or 'negative' direction) is really "stable or no change." Any change of 20% or more is likely real, but it is only by following the trend over a few months that will lend credence to your conclusion things are working or not. In addition to an increase in cancer activity, TM values can rise when there is an increase in dead tumor cells in the bloodstream (called tumor flare), since the lab test doesn't differentiate between live and dead cells; and infection and inflammation anywhere in your body can cause the TM value to rise.

Alos, Ibrance has an average time to response of 112 days, so while you might see a change in your tumor markers and/or Alk Phos if you have bone mets before about 4 months, you really can't make a determination about the efficacy of Ibrance for at least 4, and preferably 5-6 moths. So in the absence of dramatic disease progression, of new symptoms appearing in that time period, stay the course and wait until you have enough information to make a decisions. My onc also said that in the absence of new symptoms or something else concerning appearing, we would not get scans for at least 6 months after starting this regimen.

Your "increase" in TM results from 106 to 109 is less than 2% change, and means absolutely nothing. Stay calm, take a deep breath and trust that there's every reason to expect that in a few months you will have definitive evidence of how well this treatment is working for you.

Lynnwood1960

Tychad, my onc says up or down 10 points is considered stable.