Adjuvant Perjeta for stage 2A?

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stephincanada
stephincanada Member Posts: 228
edited September 2016 in HER2+ (Positive) Breast Cancer

Hi All,

I have already had surgery, but am thinking about taking four doses of Perjeta and seeing if my insurer will pay for it. This approach has not been recommended by my medical oncologist, because he says that pathologic complete response (pCR, or, making the tumour disappear) in the neoadjuvant setting does not always translate into better disease free survival or overall survival. (You can google "Eric Winer" for more on this point.) I am really struggling with this decision.

Because Perjeta is a relatively new drug, I am worried about potential side effects. My prognosis with chemo and Herceptin is already very good. I don't want to be greedy and push my luck for a few more percentage points, but at the same time, I want to do everything I can to live! The aggressive nature of my er/pr negative, HER2 positive, grade 3 tumour terrifies me.

Any guidance or insight from this group of you all would be most appreciated!

Stephanie

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  • HattieHouston
    HattieHouston Member Posts: 11
    edited September 2016

    Hi, I just completed 4 doses of Perjeta each one 3 weeks apart. I also took herceptin and paclitaxel along with it. I am 74 years old and had some mild diastolic heart failure before I began treatment. My ejection fraction was unchanged over the course of my 12 weeks of treatment. I have some edema and I have not asked which drug is causing it but I think it is the perjeta. If you take it, you will need ECHO cardiogram before and after to monitor for heart damage. I have no knowledge of how much you could gain by taking it. I did very well and had few side effects from the three meds I was taking. I had almost no nausea, a little bit of diarrhea well controlled with Immodium and I became increasingly fatigued over the 12 weeks. My blood cell counts dropped out of the normal range and my creatinine inched up to 1.3 at the very end of the 12 weeks. Liver enzymes remained the same thruout. Potassium and Magnesium tended toward the bottom of the normal range but never any worse. Everything else remained normal. Hope this helps. If you have other questions, I'll will answer if I know.

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  • stephincanada
    stephincanada Member Posts: 228
    edited September 2016

    Thanks for the information, Hattie Houston. I had my first PERJETA three weeks ago. Because I am taking it with a new chemo (docetaxel/taxotere) and Herceptin, I don't know which drug is causing which symptom! But this cocktail is much more tolerable than my previous chemo (FEC).

    I read your post about being strongly HER2 positive and not being able to find a primary breast tumour. I think that the type of tumour we have (called "enriched HER2" or "enhanced HER2") is a sneaky devil. Mine blew up to 2.1 CM in between breast MRIs that were six months apart. Being strongly HER2 is a very good thing. If you can, watch the movie "Living Proof"--it is the story behind the development of Herceptin (it is available on iTunes). There was a breast cancer patient named Barbara Bradfield who was strongly HER2 positive and Dennis Slamon, the developer of Herceptin, begged her to take part in his trial because he believed she would respond well. This proved to be the case and she is alive 20 years later, despite being stage IV in the late 1990s.

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