TCH vs TCHP

My vote is TCHP. Perjeta is incredibly promising, if relatively new. I had no SEs (that I know of) from Perjeta, and I'm very grateful to have received it, since HER2 is nothing to mess around with. The combination of Perjeta and Herceptin is, in my MO's opinion, the only way to treat any one of us who qualifies for Perjeta.

It's a targeted treatment, so you're not really adding another chemotherapeutic agent if you decide to get it. The SE that some women experience is diarrhea, but that can be controlled with Imodium.

Happy to answer questions if you have them. My diagnosis was very similar to yours.

Edited to add this: you might want to check out the triple-positive thread, too. Even if you're ER/PR negative, there's some good info there about various chemo/targeted therapy regimens.

If Perjeta is an option for you, post-surgery, I'd say do it. Absolutely.

I had TCHP after surgery, because my largest tumor was over 2cm. It's been approved. If that oncologist won't do it, my advice is to find one who will!

go for tchp- many studies showing a dual blockade has better outcomes for her2. I had it post surgery. Only side effects were diarrhea, which eventually went away after 3 months. Had tinnitus and vertigo but not sure which agent was the culprit and it was manageable

I would find an MO that would give you Perjeta. My MO (new one after surgery) automatically included the Perjeta with my Taxol and Herceptin. She said it was more effective. The insurance company didn't even question it.

Betty-PA I go to one of the top cancer treatment institutes in the country, and I am currently on Taxol+Herceptin+Perjeta, once this regimen is over I'll start AC x4. The tumor board actually reversed the order of the drugs, which was initially going to be AC first, then the THP, because of the effectiveness on this combination. Once chemo is over, I'll need surgery again (I had a lumpectomy in Dec. with bad margins and 4/4 nodes.) So I don't know if I am technically post- or pre-surgery, but I am receiving the Perjeta by a team that believes it's effective.

I would definitely have the perjeta. When I was diagnosed, I wanted to throw everything at my cancer. At that time perjeta was not approved and I did Taxotere, Carboplatin & Herceptin. My thinking was that if I had a recurrence and I didn't throw everything at it, i would be devasted that I had not thrown everything at it.

You might want to check other top cancer treatment centers to see if they offer the perjeta.

I had TCHP post limpectomy and lymph node removal surgery. I only had perjeta twice. We stopped it because I could not deal with the side effects. However my doctor stressed that have 2 doses was better than non since the drug is so promising. Right now I'm dealing with a lot of side effects from the Carboplatin. Don't be discourged by my experience, I'm just one of those people who gets all the side effects even the uncommon ones.

I'm a little late to this thread, but I wanted to add my story. I was part of a clinical trial where I had ONLY Herceptin and Perjeta before surgery. And it totally shrunk my tumor! Now I'm having Taxotere along with Herceptin and Perjeta after surgery. With the Herceptin and Perjeta before surgery, I had zero side effects. I would take those drugs for 10 years or more if they would let me. There are some people that have heart trouble on those drugs, so I'm being monitored by echocardiogram every 3 months. But so far, no changes.

I am fortunate that my insurance is still paying for Perjeta along with Herceptin. My doctor said they often deny it after surgery.