Anyone on Taxotere, Perjeta and Herceptin

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  • Kthielen
    Kthielen Member Posts: 194
    edited May 2014

    I have completed 5 of 6 of TCHP.  I have had nausea, change in taste, hot flashes, bad diarrhea, and about 12 days after treatment my skin breaks out very bad, my eyes get puffy too.  I have a constant runny nose and eyes. Although it sounds like a lot they have all been mild SE's compared to how I thought it would be.  The diarrhea has been the worst but Immodium works for me.  My fifth treatment was the absolute worst!  I am so grateful I only have one more treatment and will be over with this stage.  If you have any specific questions lmk, I would've happy to share my experience:) 

  • Kite
    Kite Member Posts: 265
    edited June 2014

    Are all these hot flashes from Perjeta?! And is anyone tender during sex? Like first time all over again tender? 

  • CoastalXPat
    CoastalXPat Member Posts: 83
    edited June 2014

    Hi All, So I'm getting TCHP but in the adjuvant setting. Is anyone else doing this? Apparently I'm lucky that my insurance is covering it, o/w it wouldn't happen. 

    Btw a family friend who is also a oncologist said that adding Perjeta to TCH tends to increase side effects, especially the digestive ones.

  • carolsue63
    carolsue63 Member Posts: 126
    edited June 2014

    I can believe that. I did TCH 4 years ago and just finished 6 rounds of TCHP last month. TCHP was much, much harder for me. I don't know if it's because of adding the Perjeta, or just because it was my second time having chemo. Maybe both.

  • Kite
    Kite Member Posts: 265
    edited June 2014

    carolsue- it was much harder for me too. My onc switched me to kadcyla since my mets are stable. I only made it through 2 rounds.

  • marvelher2
    marvelher2 Member Posts: 62
    edited June 2014

    Hi everyone,

    It has been a long time since I posted on here, mainly because chemo had me pretty sick, and I didn't want to be a bummer for those of you going through this new protocol because it looked like I wasn't following the same wonderful course.  

    Well, I made it through my six sessions of Taxotere, Carboplatin, Herceptin and Perjeta, and had a bilateral mastectomy with immediate reconstruction on May 30th.  I just received the pathology report day before yesterday, and I was very surprised.

    For those of you that remember me from my initial posts, my initial diagnosis was IDC, 2.5 cm extending to 6 cm with suspected involved DCIS.  This got me the neoadjuvent treatment including Perjeta which had just been approved for neoadjuvent treatment only for early stage bc with tumor size 2cm or more.  The tumor was 0% ER/PR staining, 100% staining 3+ Her2Neu over expression.

    But then I had a pesky MRI and they found another separate lesion, prompting an MRI guided biopsy on a tiny 4mm finding.  Turned out this one was ER/PR positive, Her2 negative and again invasive, but only grade 1.  But it was so inconsequential compared with the other tumor, they decided to go forward with the neoadjuvent chemo regimen targeting only the Her2 positive tumor.

    In early April I had another Pet scan, and the Her2 tumor seemed to be shrinking, but still there, but the hormone receptive one seemed to have grown tremendously.  I thought what they were looking at was a hematoma from the biopsy because I had sustained a huge bruise on that breast that lasted months, so I wasn't too concerned.

    Well, here's the interesting part.  The pathology report is in, and that nasty Her2 positive tumor is literally gone!  I had a complete pathological response cPR on that tumor, and all that was left was the clip.  BUT, the little 4mm hormone receptive tumor grew from 4mm to 3.7 cm in that short time between starting chemo in January and surgery in May. It also changed from grade 1 to grade 2, SBR score 7.  There was also expansive DCIS grade 3, central expansive "comedo" necrosis.  Apparently that means there were dead cancer cells throughout my ducts, I assume from the suspected DCIS surrounding the first tumor.

    I am literally a petri dish for effectiveness of this chemo regime for Her2 positive neoadjuvent targeted therapy because it shows how incredibly effective the Herceptin and Perjeta were in targeting the Her2 proteins, but yet the hormone receptive tumor was literally growing out of control because I had no hormone targeted therapy during this time.  My surgical oncologist believes that it grew so rapidly due to my immunosuppression during chemo.  It goes a long way to prove the protocol of neoadjuvent treatment for Her2 positive cancer, but for hormone receptive cancer, immediate surgery and adjuvent treatment later.  

    I am so happy with the outcome of the more dangerous Her2 positive tumor.  And, I am so thankful for UCLA Dr. Dennis Slamon for his work on Herceptin, and now his involvement with Perjeta.  Having the opportunity to see so clearly the effectiveness of this targeted therapy with my unique situation with the two tumors really sends home how fortunate we Her2 positive patients are to be treated now and not 15 years ago.  

    My next hurdle is getting through this rather painful mastectomy and reconstruction surgery.  That's a story for another thread….

  • ednamary
    ednamary Member Posts: 5
    edited June 2014


    I had my 1st treatment 2 weeks ago and it really did "kick my butt". I had diarrhea, developed sores in my mouth and a face rash. Was also very tired and really didn't want to eat. The shot neulasta was a killer didn't know what to do with my body but by the middle of week 2 everything started to improve. My next treatment is next Thursday  I am not looking forward to it but I think I am ready having learned much from the SE of the first one. I suggest you have Gatorade in the refrigerator and drink it very frequently, make jello in advance,  and avoid citrus. Also drank Sprite Zero because ginger ale burned with the mouth sores. The oncology nurse also recommended that I have baking soda toothpaste and Tom's of Maine mouth cleaner (it has no alcohol) in the house. both those things really helped and are available in the supermarket. good luck and above all be confident that the triple play will do it job.

  • Jaytee
    Jaytee Member Posts: 1,211
    edited June 2014

    I just started thp this week on Wed 6/11/14  for treatment of mets in my lung and liver. I will be on the herceptin and perjeta for at least a year. I am not sure how many rounds of taxotere I will be taking. I definitely have that knocked down feeling already. They are going to take some labs on Tues to determine if I will need a neulasta shot...hoping that I will not.  Thursday night, I barely slept...last night I think I fell asleep as soon as my head hit the pillow and I don't think I changed sleeping positions the whole night cause I woke up feeling like a turtle stuck on its back. Felt better as I got moving around. Appetite is not very good...but I am trying to make sure I eat at least small meals and trying to eat yogurt as much as possible. Haven't had any diarrhea issues yet....but have been struggling with  constipation because of needing to take some pain medication for pain  in the liver area.  My treatments will be every 3 weeks. I have dreaded the thought of chemo again and dealing with the side effects but am glad that we have started  fighting this thing. Sounds like for a lot of you the regimen is working and that is encouraging to me..wishing everyone on here the best.

  • redhummer
    redhummer Member Posts: 2
    edited June 2014

    I started taxotere,  herceptin,  and perjeta in November 2013.  When I had surgery in March 2014 my tumor was gone and only a .01 millimeter cancer cell was found in 1 lymph node. I had 16 removed. The side effects during chemo were awful. I lost all my hair, eyebrows,  and my skin was extremely dry. I had sores in my mouth, nose, any other area that had any type of moisture. Yep even down there!. I had diarrhea the whole time even though I took lomotil. Now I'm finished with radiation and I have 8 more herceptin treatments.  It was hard but it works and I am cancer free!!!

  • oconnor2450
    oconnor2450 Member Posts: 58
    edited June 2014

    Hi! I also have not posted in a while. Finished rads 3/26. Continuing Perjeta and Herceptin until Sept, for a complete 1 year cycle.

    Once the Abraxane( Taxol) part of the chemo was finished, SE's really diminished. I do have the the big D, pretty sure it's from the Perjeta...and it can strike at any time...ugh. I have 5 infusions of P&H left.!!  Started Arimidex June 1...too soon to say, hope any SE's will be negligible. So happy to hear of everyone doing well on the Perjeta Herceptin cocktail. Just staring to feel somewhat normal again. Of course, it's new normal:)

    My best wishes to everyone, hang in there, keep swimming!!!

  • CoastalXPat
    CoastalXPat Member Posts: 83
    edited June 2014

    It sounds like the THP and TCHP is kicking a lot of butts - I know it kicked mine, and I decided to stop after 4 rounds. I already had my lumpectomy and am stage 1, so I have no real idea of how much this is helping other than by reading about the studies and statistics. I got so many of the SE's - not quite all of them, but most of them. We'll see how it goes with just Herceptin for the next 9 mos.

    Re. mouth sores, I found two things that really seemed to help. BMX helped to ease the pain - it's a mix of lidocaine, maalox, and pepto bismol, your phamacist can mix it w/a prescription. It makes your mouth numb for the first ~20 minutes, but then the painkilling effect seemed to linger for a good while. Second, my acupuncturist told me to suck on mints to help saliva production, which helps to protect the mouth. I did this faithfully during rounds 2 & 3 and didn't get any mouth sores even though my mouth was (and still is) pretty dry.  But now I can't wait to just heal. I really miss flavorful food.

  • Jaytee
    Jaytee Member Posts: 1,211
    edited June 2014

    Well, I have gone a couple more days and think it's safe to say that I probably won't have too much more problems with constipation! It must be the perjeta...I don't really remember having diarrhea when I had a year of herceptin back in 2011.  Will have to look at this as a  blessing in disguise...I was feeling miserable with the other problem.  

    Didn't sleep very well last night....just couldn't seem to get comfortable, but sitting here in a recliner this morning, I feel like I  could take a cat nap. 

    redhummer....congrats to getting to that great place....cancer free!!! 

    ednamary....good luck on your next treatment on Thurs....Will be thinking of you.

    Take care everyone..........judy

  • elabee
    elabee Member Posts: 20
    edited June 2014

    I lurk a lot but figured I should share my experience with TCHP.

    I completed the six founds of TCHP at the end of March. In an effort to preserve my fertility, I also opted for Lupron shots during chemo. My oncologist wasn't sure it is going to work but I figured I had nothing to lose.

    I found chemo to be really difficult with some good days and plenty of bad days (thanks chemo and neulasta). I found the not wanting to eat and the GI issues to be hardest.

    All that being said, my pathology showed a complete pathologic response in both my breast tumor and armpit tumor. Reading marvelher2's results makes me wonder if lupron helped the chemo be more effective by shutting down my hormones.

  • ellamilana
    ellamilana Member Posts: 76
    edited July 2014

    Hi, last week i had my 4 of 6 PHT treatments. I have next to nothing SE, its almost scary. I am a bit tired now and then, but never missed a day of work and I am driving to get to work. My onc like to have a follow up a week after a chemo, and I had one today. Even my blood test was normal. I am concerned, if this is working for me and my onc ordered PET scan... Should I be worried? is it to good to be true?  

  • marvelher2
    marvelher2 Member Posts: 62
    edited July 2014

    Hi Ladies,

    It's been a while since I last posted.  Here's the scoop.  When I finally received the actual pathology report, I began to question what I'd been told by my surgeon that the Her2 tumor had dissolved, but the ER/PR tumor had grown.  The PET scan I had in April even said there was a 3.5 cm tumor at the biopsy site of the ER/PR tumor.  I had always believed that they were looking at the hematoma that developed after the MRI biopsy.  After I received a copy of the pathology report and reading the report over and over, the anatomical markers mentioned in the report just didn't add up to me.  When I brought it up to my Surgical Oncologist, I received a rather defensive reaction, stating that he didn't think it was wise for patients to try to analyze their pathology results, but finally said if it would make me happy he would order a test on the tumor to confirm which tumor was remaining.  I don't think he ever ordered that test as I have not heard back from him.

    When I went back for my first weekly dose of Herceptin four weeks after surgery, I asked my Oncologist to read the report carefully and tell me what he thought.  He at first came to the same conclusion as I did, but after talking with the pathologist went back to the thought that it was the ER/PR positive tumor remaining.  Apparently they don't test the tumor type generally if it has been biopsied.  With me having two totally different cancer types, they really should have done that. He was very concerned about the aggressiveness of the tumor, and wanted to order an Oncotype DX test to determine the tumor's likeliness of recurrence.  He is also sending me to a specialist at UCSF due to the complexity of my case.

    I had an appointment with him this Tuesday to go over the results of the tests to the tumor, and low and behold, I was right.  The remaining 3.7 cm tumor was actually the Her2 positive tumor, and the ER/PR positive tumor was zapped by the Taxotere.  Since Oncotype DX is only performed on hormone positive tumors, there was no need for that test.   So that was good news and bad news.  No rapidly growing hormone positive tumor to deal with, but a very persistent Her2 positive tumor.  He spoke at length with the pathologist who believes the tumor had actually started out to be 7.2 cm based on the necrotic tissue surrounding it.

    At least I won't have to go through more chemo at this point because had it been the hormone positive tumor, my Oncologist was concerned that I should have a different blend of Adjuvent therapy for the ER/PR positive tumor.  He still wants me to see the specialist in SF because he says 80% of patients now receiving this combination of drugs have a complete pathological response, but mine did not respond as well which concerns him.

  • Tinkerbells
    Tinkerbells Member Posts: 211
    edited July 2014

    marvelhr, how lucky you were to stand up for yourself- good for you. You will be in good hands at ucsf- I'm sure they will reevaluate all your histology and pathology results. Perhaps they will consider kadcyla, which will target the her 2 and only the her2 cells. Good luck and keep us posted- we are with you.

    Sandra

  • Teachingwithcancer
    Teachingwithcancer Member Posts: 27
    edited July 2014

    Hello ladies! I have not posted in a while. Just came across my old friends herceptin projeta and taxotere. Yes I call them friends bc I'm here today. I was DX May 4, 2013 (May the 4th be with you, a joke a former student told me). I had 6 rounds of taxotere, perjeta, and herceptin first. I begged my team to let me return to work in sept 2013. I was on herceptin and perjeta every 3 weeks. Went in on Friday mornings before work. Would sleep all weekend.  I postponed my surgery until November. I had a bilateral mastectomy with TEs. All was well until 1 month later left TE became infected and removed. But still able to return to work in January after Christmas break. Planning on replacing TE during spring break but I'm the small percentage that perjeta and herceptin caused CHF. So heart was functioning at 30%. In comes cardiologist placed on heart meds monitor heart with MUGA scan. ❤️ Function increased to 56% which is normal. Started at 65% before chemo. Left TE replaced 7/25. My summer break started 7/22 (year around school). I have had 2 PET scans which were clear. Will have another in 2 weeks. We,my team and husband will decide how to proceed after results. Sorry so long just reflecting. New people it is a fight but find something or someone for fight for. I fought to teach and see my daughter start kindergarten. I'm winning that fight now I will focus on my next fight. But it is a fight. I'm not fighting alone my husband my medical team my parents my daughter my students my fellow teachers are all fighting with me in some way. Keep strong

  • tlj030
    tlj030 Member Posts: 10
    edited July 2014

    I had the mouth sores really bad and doctor suggested that I keep ice chips in my mouth during chemo. This really helped me. I still got a few and my taste buds issues were not as severe. 

  • ednamary
    ednamary Member Posts: 5
    edited July 2014

    I have my last chemo tomorrow and I am scheduled for surgery on the 25th of August. I start chemo again in September for a least one year. The taxotere, perjeta, and Herceptin seemed to have done their job, My tumors did shrink. The protocol was really difficult. As many of you were and are, I also was really sick after each chemo and extremely tired. I have a prescription for mouth sores that helps. It is used before meals and at least I can put some food in my mouth. Does anyone have a constant metal taste from the chemo? What do you eat that taste somewhat normal? I see that most of you have the big D also. That certainly keeps me home a great deal when I am not at work.(which sometimes is a problem) lomotil doesn't always help.Just know I think of all of you often, you are a great support group.

     


     

  • tlj030
    tlj030 Member Posts: 10
    edited August 2014

    The metal taste was an issue with my chemo. I could only eat scrambled eggs or potato soup  until my taste buds returned.

  • agness
    agness Member Posts: 576
    edited August 2014

    I did neoadjuvant TCHP, March through the beginning of July for 6 treatments. My MO gave me a 7th dose of Perjeta before my surgery.

    I had additional bloodwork done during my treatment and my magnesium level was always low in spite of supplementation. I didn't have too many problems with altered taste until the last two rounds, my naturopathic oncologist had me taking double strength zinc to help in this regard, plus I restricted shellfish, coffee and chocolate as my copper levels were high. 

    My ferritin level was low at the start but with Floravital liquid iron supplement and also Chinese herbal medicine in-between infusion weeks, my bold counts were really decent until after round 6 when I hit the edge. I'm still trying to rebound and am making progress slowly but my granulocytes were still dropping 6 weeks PFC. 

    My MRI and ultrasound the day after dose 6 showed no tumor, only the calcifications that were there before. Two lymph nodes still lit up but they didn't know what it was.

    I had my lumpectomy and SND this past week and my pathology report came back with no sign of cancer. I need to get a copy of the report but the best news was that my 3 nodes were clean, with one showing scarring, since I also had an infected node behind my breastbone that they weren't going to address surgically.

    I asked a lot of questions about why if there was expected to be only microscopic disease left and rads are supposed to treat microscopic disease, why then did I need surgery. They all had their reasons and I looked for research articles but there is such limited data on HER2/neoadjuvant treatment/Herceptin with Perjeta that I resigned myself to having the least amount of surgery that was still intended to have a therapeutic advantage.

    Now I'm questioning the merits of rads. They really don't know much at all about Perjeta it seems.

    A toast to Perjeta and Herceptin for changing the game. May research catch up with results.

    Ann

  • chrissie29
    chrissie29 Member Posts: 121
    edited August 2014

    Hi.  I am new to this site.  I am premenopausal and was diagnosed with Stage IIB Invasive Ductal Carcinoma, ER/PR/HER2+ at the end of July 2014.  My tumor is quite big (up to 8.4 cm on MRI).  I started with Taxotere, Perjeta, and Herceptin on 8/8.  I am supposed to have that regimen every 3 weeks for 4 cycles and then have surgery.  I see some are having another chemo agent and having 6 rounds.  Does anyone know if there is some advantage to having this extra drug or not and having more cycles?  Has anyone with ER+/PR+/HER2+ had just the 3 drugs for 4 cycles and had success in shrinking the tumor?  Wondering if I should be asking the oncologist to add the other chemo agent and for more cycles.  Thank you.

  • Gailgie
    Gailgie Member Posts: 2
    edited August 2014

    I have Stage IV metastasis to brain, lung and liver. I am managing herceptin and perjeta ok now every three weeks for over a year. Echocardiograms and CT scans have been ok.  

  • Moderators
    Moderators Member Posts: 25,912
    edited August 2014

    Welcome to BCO Gailgie. We are happy you found this forum but sorry you needed to be here.

    You will find quality info on your treatment drugs on our main Breastcancer.org site like How Herceptin Works and Perjeta, which you undoubtedly know about, but these are just examples of what you can find there as well as here on the Forum.

    You are not alone and many peoples' best wishes will go with you to treatments and scans.

    We wish you all the best

    The Mods

  • Beatmon
    Beatmon Member Posts: 1,562
    edited August 2014

    going to start perjeta, herceptin, taxotere on Wednesday. Had bm 2 yrs ago, neg sentin node . 2 - 4 mm  her 2 neu grade 3, large dcis... No chemo..did not met protocols.  In the hospital 10 days ago for r/o implant infection and instead found. 40-50 small lung nodules that were proved cancerous by lung biopsy. What can I expect ladies? 

  • Jaimieh
    Jaimieh Member Posts: 2,373
    edited August 2014

    Beatmom the herceptin and perjeta are know for diarrhea and a little flu like feeling. 

  • Beatmon
    Beatmon Member Posts: 1,562
    edited August 2014

    how successful has it been for most on these discussion  boards?

  • tlj030
    tlj030 Member Posts: 10
    edited August 2014

    Agness, my treatment is just like yours. I start my radiation next month. 

  • agness
    agness Member Posts: 576
    edited August 2014

    tlj030 - may I ask why you didnt do neoadjuvant TCHP. It looks like you did surgery first yet our diagnosis of only HER2+ has the highest pathologically complete rate for neoadjuvant chemo plus Herceptin. Were you not interested in breast conservation? I know some gals just want to remove the breast so I am curious as to what influenced your treatment path.

  • agness
    agness Member Posts: 576
    edited August 2014

    If anyone used neoadjuvant TCHP and would like to share their outcome I posted a new thread over here

    Neoadjuvant TCHP Results

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