Anyone on Kadcyla (TDM1) and have a bad rash??
I started on Kadcyla last April after 5 years of Herceptin ended due to progression. I've gotten an angry itchy rash on both forearms, front and back of chest and neck and a few spots on my nose. After last infusion a rash went down the back of my throat and thankfully improved in 5 days. Very odd, painful and also confusing due to just finding out Its am a Celiac patient- Celiacs can manifest on skin too, although typically in other places than my rash. Anyone out there?????
Comments
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HI there, I'm sorry I am of no help but am responding to bring this back up to the top. I know someone will be along soon to offer some insight
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I was on Kadcyla for 10 months, took a break and now back on it. I have had many sise effects...but never a rash. We have a very long thread on TDM1-Kadcyla running on this board....you should read through that to see if anyone else had a rash.
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Hi Longtimesurvivor! Here is probably the thread that Denny mentions: Topic: Who's on Kadcyla/TDM1?. You may find some answers there. Good luck! Hope you feel better soon.
The Mods
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Thank you for your reply!! I have found the thread you mentioned (thank you too, Moderators!), and am hungrily reading through it. Nothing on rashes, but learning lots anyway!
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Many thanks!!
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my dr just discussed starting me on kadcyla...no mets anywhere, er, pr, HER2 positive. Had left mastectomy about 5 weeks ago for recurring cancer but no mets. Anyone getting kadcyla that does not have mets? So far all I have done is take Tamoxifen, then switched to Letrozole and had radiation with initial diagnosis 4yrs ago.
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I just gor my ist dose of kadcyla reluctantly cause I do not have mets and cea and ca27-29.keeps coming down after my mastectomy. Feeling tired wirh flu like symptoms.
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I am starting Kadcyla Friday 5/25/2018 I will keep you posted. I have breast cancer mets. This is my third round of chemo. I too was on Herceptin/Perjetta and faslodex for the past few months and the cancer is back but localized. Getting petscan 6/11 to see if it has travelled. My mastectomy incision never healed. Using cream on it daily. Surgeon told me NO more surgery, NO more radiation. God I hope this works. I work full time and I am worried. I am Her2 Positive as well. bumps showed up near incision and underarm of surgery site.https://www.faslodex.com/
Getting two shots in the butt of faslodex monthly and 1 shot of Xgeva in the arm monthly. Taking a LOT of vitamins.
Kadcyla
Important Safety Information & Indication
Indication
KADCYLA®(ado-trastuzumab emtansine), as a single agent, is indicated for the treatment of patients with HER2-positive (HER2+), metastatic breast cancer (MBC) who previously received trastuzumab and a taxane, separately or in combination. Patients should have either:
- Received prior therapy for metastatic disease, or
- Developed disease recurrence during or within six months of completing adjuvant therapy
Important Safety Information
Boxed WARNINGS: HEPATOTOXICITY, CARDIAC TOXICITY, EMBRYO-FETAL TOXICITY
- Do not substitute KADCYLA for or with trastuzumab
- Hepatotoxicity: Serious hepatotoxicity has been reported, including liver failure and death in patients treated with KADCYLA. Monitor serum transaminases and bilirubin prior to initiation of KADCYLA treatment and prior to each KADCYLA dose. Reduce dose or discontinue KADCYLA as appropriate in cases of increased serum transaminases or total bilirubin
- Cardiac toxicity: KADCYLA administration may lead to reductions in left ventricular ejection fraction (LVEF). Evaluate left ventricular function in all patients prior to and during treatment with KADCYLA. Withhold treatment for clinically significant decrease in left ventricular function
- Embryo-fetal toxicity: Exposure to KADCYLA during pregnancy can result in embryo-fetal harm. Advise patients of these risks and the need for effective contraception
Additional Important Safety Information:
Left Ventricular Dysfunction (LVD)
- Patients treated with KADCYLA are at increased risk of developing LVD. In EMILIA, LVD occurred in 1.8% of patients in the KADCYLA-treated group and in 3.3% in the comparator group. Permanently discontinue KADCYLA if LVEF has not improved or has declined further
Embryo-Fetal Toxicity
- Verify the pregnancy status of women of reproductive potential prior to the initiation of KADCYLA
- Advise pregnant women and females of reproductive potential that exposure to KADCYLA during pregnancy or within 7 months prior to conception can result in fetal harm
- Advise females of reproductive potential to use effective contraception during treatment and for 7 months following the last dose of KADCYLA
- If KADCYLA is administered during pregnancy or if a patient becomes pregnant while receiving KADCYLA or within 7 months following the last dose of KADCYLA, immediately report exposure to the Genentech Adverse Event Line at 1-888-835-2555
- Encourage women who may be exposed to KADCYLA during pregnancy or within 7 months prior to conception, to enroll in the MotHER Pregnancy Registry by contacting 1-800-690-6720 or visiting http://www.motherpregnancyregistry.com/
Pulmonary Toxicity
- Cases of interstitial lung disease (ILD), including pneumonitis, some leading to acute respiratory distress syndrome or fatal outcome, have been reported in clinical trials with KADCYLA. In EMILIA, the overall frequency of pneumonitis was 1.2%
- Treatment with KADCYLA should be permanently discontinued in patients diagnosed with ILD or pneumonitis
Infusion-Related Reactions, Hypersensitivity Reactions
- Treatment with KADCYLA has not been studied in patients who had trastuzumab permanently discontinued due to infusion-related reactions (IRR) and/or hypersensitivity reactions; treatment with KADCYLA is not recommended for these patients. In EMILIA, the overall frequency of IRRs in patients treated with KADCYLA was 1.4%
- KADCYLA treatment should be interrupted in patients with severe IRRs and permanently discontinued in the event of a life-threatening IRR. Patients should be closely monitored for IRRs, especially during the first infusion
Hemorrhage
- Hemorrhagic events, sometimes fatal, have been reported in clinical trials. In EMILIA, the incidence of ≥Grade 3 hemorrhage was 1.8% in the KADCYLA-treated group and 0.8% in the comparator group (overall incidence 32.2% and 16.4%, respectively)
- In some of the observed cases, the patients were also receiving anticoagulation therapy or antiplatelet therapy, or had thrombocytopenia; in others, there were no known additional risk factors. Use caution with these agents and consider additional monitoring when concomitant use is medically necessary
Thrombocytopenia
- In EMILIA, the incidence of ≥Grade 3 thrombocytopenia was 14.5% in the KADCYLA-treated group and 0.4% in the comparator group (overall incidence 31.2% and 3.3%, respectively)
- Monitor platelet counts prior to initiation of KADCYLA and prior to each KADCYLA dose. Institute dose modifications as appropriate
Neurotoxicity
- In EMILIA, the incidence of ≥Grade 3 peripheral neuropathy was 2.2% in the KADCYLA-treated group and 0.2% in the comparator group (overall incidence 21.2% and 13.5%, respectively)
- Monitor for signs or symptoms of neurotoxicity. KADCYLA should be temporarily discontinued in patients experiencing Grade 3 or four peripheral neuropathy until resolution to ≤Grade 2
HER2 Testing
- Detection of HER2 protein overexpression or gene amplification is necessary for selection of patients appropriate for KADCYLA. Perform using FDA-approved tests by laboratories with demonstrated proficiency
Extravasation
- In KADCYLA clinical studies, reactions secondary to extravasation have been observed and were generally mild. The infusion site should be closely monitored for possible subcutaneous infiltration during drug administration. Specific treatment for KADCYLA extravasation is unknown
Nursing Mothers
- Discontinue nursing or discontinue KADCYLA, taking into consideration the importance of the drug to the mother
Adverse Reactions
- The most common (frequency >25%) adverse drug reactions (ADR) across clinical trials with KADCYLA were nausea, fatigue, musculoskeletal pain, hemorrhage, thrombocytopenia, increased transaminases, headache, constipation, and epistaxis. In EMILIA, the most common severe adverse reactions Grades ≥3 (frequency >2%) were thrombocytopenia, increased transaminases, anemia, hypokalemia, peripheral neuropathy, and fatigue according to NCI-CTCAE (version 3)
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June 5, 2018. Getting ready for an updated petscan. My cancer bumps are breaking open. Some are bleeding and others are very red and irritated. They itch but they are only in two areas, my shoulder and the fat behind my shoulder. I do have three bumps on my left clavicle area that have broken open like pimples but the pimple is hard. They do not bleed. My incision from my mastectomy is still not healing over. I am keeping it very clean and using REVO to help with the pain. Revo is a Hemp product/ sauve. So far the most comfortable cream. Look out for
Silver Sulfadiazine
PEP Topic RadiodermatitisDescription
Silver sulfadiazine is an antibacterial agent that has been used as a topical cream on burns. Silver sulfadiazine has been studied for its effect in patients with cancer for radiodermatitis.
it has sulfur, it made me break out in a rash. Allergies!@!
Very weird reaction. I have had bumps grow after my first chemo but never during chemo. Is this normal ? Anyone else. I am willing to share a picture.
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Hi , I too have been on Kadcyla/Herceptin 3rd round chemo. I found that rashes and bumps that break open are cancer but most are from blood sugar. Go to an endocrinologist and get your sugar checked. It is very hard to heal on chemo. I am still nursing my incision after 7 months post surgery. More doctors need to look at the patient holistically not just based on chemo protocol.
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