Herceptin without Chemo- 6mos vs 12

janz · June 2009

Just curious if anyone is having just Herceptin without chemo? And if so, are you on a 6 month treatment plan or a 12 month plan?

I had TRAM reconstructive surgery in January. Started Armidex and Herceptin in March. My Dr said we would talk again after I had finished 6 months of Herceptin treatments(every 3 weeks). She said sometimes 6 months is enough and sometimes people do 12 months. I was just wondering what others were doing.

Thanks so much

Jan

orange1 · June 2009

Hi Jan -

The standard treatment is 12 months - this is the duration that was tested in the large clinical studies. It is unknown if 6 months is just as effective, especially since you did not have chemo. There are some small studies that showed less time on Herceptin is as effective as 12 months (e.g. FinHer) , but in this study patients were given a lot of chemo at the same time. It is believed that chemo and herceptin given together is more effective then when Herceptin is given alone.

However, your tumor was small and grade 2 (most Her2+ tumors are grade 3). Based on your tumor characteristics, you have lower risk of recurrance than the patients who participated in the large adjuvant studies (70% Grade 3, all tumors > 1 cm). This is probably the reason your onc did not recommend chemo. You are in uncharted territory here. Sorry I can't be of more help.

Based on all I've read, if it were me, and insurance was paying for the herceptin, and if no heart problems - I'd do the whole year of Herceptin.

Good Luck

juliejfsrj · June 2009

I did just herceptin every three weeks for one year. I believe 18 treatments. Good luck!

janz · June 2009

Thanks so much for your replies!!!!

GramE · June 2009

I had 4 Dose Dense A/C (chemo), then 12 Pacllitaxol (chemo) and Herceptin, - shrunk, zapped my tumor to only dead cells when the lump was done. then Herceptin only - every 3 weeks since January. I will be finished July 16 (a year) since I began with P and H.

I was told one year of H for Her2 + is the wonder drug, but you cannot get it without some form of chemo first or with (at least where I go for tx).

To avoid side effects - mainly dizzy and blurry vision, they slowed the drip to an hour (usual time is 30 minutes) and added saline drip before, during and after to dilute it and keep me hydrated.

IF you are doing this long term, I highly recommend a medi port to save your veins. Ask other questions and I will check back to see if I can help. Nancy

BorneoMom · July 2009

Hi Nancy, I'm so glad I read you post. I've been on Herceptin since April 22, and have had 2 doses Taxotere & Cytoxin. My main complaint has been a very dizzy head, and, especially the second round, blurry vision. I couldn't find anyone who had the same SE's. I'm glad I'm not alone--not that I'm glad you had the same--it's pretty hard to live with. But, I will talk to my onc next time about slowing the Herceptin way down to see if that helps--can't hurt.

Jan, our diagnosis is very similar. Had a mastectomy, right side, and imeediate TRAM recon in March. I was really wondering if I needed chemo, but my onc said that doing both Herceptin & chemo decreases the chance of a recurrence. So I'm doing both, 4 chemo, then back to just Herceptin once every 3 weeks till next April! Lois

NanaA · July 2009

I did the taxol along with herceptin and am now doing just the herceptin until next March. My onc said they would not normally do just the herceptin even tho it is what gives better results than the chemo. Herceptin is supposed to work better if started along with chemo. Some insurance companies do not pay unless started with chemo I have heard, since it is not the standard practice.I have not had any problems with the herceptin that I can trace to it. Still having some se's left over from the taxol. Neuropathy in hands and feet and some pain in arms and legs like an inflamed nerve. I twisted a knee back in Feb. and the inflamation will not heal yet because of the chemo. Now that I am done with chemo we are trying celebrex an antinflamitory to see if we can get it healed up. So far it is better but a long ways from being gone. I think there is still alot of chemo se's left which get in the way of healing. Had MRI and CT scan to set up for Rads and they apparently did not show anything, because onc did not comment on them at set up. I will see him again when start rads and ask about them, but I am pretty sure I would have been called if they had showed something. I really did not expect anything. But with bc you never know.

swimangel72 · July 2009

Hi Jan - I had a mastectomy and immediate free-tram flap and thought I was done (except for Arimidex) until my Fish report came back showing the tumor was Her2++++. So my onc said I needed chemo plus Herceptin - because there were no studies showing Herceptin's effectiveness alone. My onc put me on a "mild" chemo - Navelbine - for 4 months every two weeks with Herceptin, then continued the Herceptin every two weeks for the rest of the year. I had three other oncologists agree with this treatment - they all said since my tumor was only Stage 1 and Grade 1 it would be effective. The Navelbine didn't cause me to go bald (although my hair did get thinner) and it didn't damage my heart; my worst side-effect was diarhea which only lasted one night after my infusion. I did get a port - but after using it only twice, it became infected and had to be removed. I had no problems getting my infusions through a vein in my hand (although the infusion nurse was very careful to infuse both drugs slowly and with saline.)

I hope this info helps you - my advice it to ask your onc for studies showing the effectiveness of Herceptin alone for 6 months - then get a second or even third opinion from different oncs. Good luck!

Herceptin without Chemo- 6mos vs 12

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