No AC after just 12 rounds of taxol/herceptin perjeta?

Caligrandma

Hi all. I just found this community and am so hopeful somebody might have my situation since I can find no study regarding what has been proposed for me. I was diagnosed with Stage 2 (2.5m) Her2+/ER+/PR-, Grade 3 in March. No node involvement ascertainable (on MRI, ultrasound or Pet scan), but 3 smaller additional satellite tumors in the same quadrant found on initial MRI.

I am in a study which gives Her2+ patients 12 neoadjuvant weekly rounds of paclitaxol plus weekly Herceptin, and every three weeks (4 total doses) Perjeta, followed by 4 rounds of AC (every other week). Then surgery. Then reinstitution of Herceptin and Perjeta.

It looks like the initial 12 week treatment has so far "worked" from the interim MRI's, and the current suggestion is to dispense with the AC portion of treatment, and go right to surgery if the MRI following the 12 paclitaxol weeks looks like no discernible cancer is left.

Because of the aggressive nature of Her2+, I'm scared to forego the AC, But when I signed up, I didn't realize the Herceptin would be totally stopped for almost 3 months during the AC and surgery portions of the plan. Since Herceptin is supposedly the "magic bullet" this long interruption concerns me.

Anybody skip the AC after paclitaxol in this kind of situation? Anybody have any thoughts? Thanks so much for being here!!!

ElaineTherese

Hi!

I did AC +THP, too, but did the AC first. During the AC, I got no Herceptin (both Adriamycin and Herceptin can harm the heart so they never give them together). Just because I wasn't getting Herceptin during the AC doesn't mean that my tumor grew during that portion of the treatment. Instead, my tumor visibly shrank during the AC. Also, like you, I took a break from Herceptin for surgery. No, my cancer did not come back because I took that break.

It's up to you about whether to do the AC. You will only know (for sure) if THP worked after surgery and you get the pathology report back. After chemo, my MRI and PET scan showed that all the active cancer was gone from my breast and compromised node. The pathology report showed that to be the case, but also indicated that I had a tiny pocket of DCIS which was removed during surgery.

In any case, even cancer that is Grade 3 doesn't grow as quickly as you think. Taking such a break from Herceptin won't make much of a difference.

Caligrandma

Thanks ElaineTherese! Input from somebody who has "been there" really helps. So glad you have had such fabulous-sounding results! How has the aromatase therapy gone?

ElaineTherese

Well, I was premenopausal when diagnosed, so I'm doing Zoladex (to put me in menopause) and Aromasin (Aromatase Inhibitor). I've done about 3.5 years, and I've had the following side effects: hot flashes (which have diminished with time), moodiness (disappeared after my oncologist put me on Celexa), and full-blown osteoporosis (now being treated with Prolia). Oh, and I gained 20 pounds, but I'm working on that this summer (have lost 5 pounds so far). I haven't had any of the joint pain that others complain about, though I do feel a little creaky getting out of my chair if I've been sitting too long.

Hope your THP has been manageable; other than the hair loss and the mild diarrhea (treated with Imodium), I preferred it to AC.

Moderators

Caligrandma, welcome and we too are happy you found us here. Glad you've had great responses