8 years, 7 lines of treatment

I don't know of other TX but I do want to congratulate you on your eight years. Curiously where are your active mets, now?

Sunset, I have no sage words for you. I would second Holmes’ suggestion of clinical trials. I know it is frightening to think that options are limited. I am on my fifth line of treatment in less than four years, and I am avoiding thoughts of what that might mean. My MO did tell me that there were several clinical trials that I might be eligible for. I am vanilla, too. Although I always thought I would jump at the chance to try a trial, I surprised myself by choosing Taxol first. When this fails, I will definitely consider a trial because some people on these boards have seen some longer responses when they participate.

You did not mention how you are feeling. I think it becomes particularly difficult to believe we are running out of options when we feel well, and in many cases even normal. How can this be?

I do hope that Gem/Cis are effective for you and remain effective for much longer than expected. Everyone is different, and that combo might be your magic bullet. I also hope that there are breakthroughs coming soon for all of us.

You have been a great source of supporte for many of us here. I am sure someone will post about their good experiences soon so you can receive the encouragement and support you deserve.

Hugs and prayers from, Lynne

My wife is pretty much at the same status. She is an eight years survivor with liver mets. Strong er/pr positive her2 neg. She has exhausted all hormonals and is now on taxol carboplatin avastin combo. She has just completed first month of treatment. In parallel we have received the first biopsy results that showed that immunotherapy could not be applied. PIK3CA is not mutated as eell so Alpalisib is ruled out. We are still waiting for TMB (another test for immunotherapy).

I am trying to figure out the next steps and the only thing I see is more chemo and possibly tamoxifen.

Any other ideas are more than welcomed.

There is one thing that I am trying to figure out. After a chemo break can someone go back to the same regimen if it has helped to reduce tumor?

Beautiful Sunset, like you, I am heavily pretreated. Congratulations on 8 years. It has been 6 1/2 years since I was diagnosed with liver and bone mets. I've had several lines of treatment with short or no effectiveness, but Doxil gave me 20+ months. Treatment after Doxil was ineffective, and options were sparse. My oncologist recommended tamoxifen (which I first had from 1989-2000), and this time it worked well for 13 months . Since progression with it, I've been on Verzenio for 7 months, and scan last month showed some improvement. You had mentioned Tamoxifen, and it certainly is worth a try. Same with Verzenio. There are some options, although I do wonder about post-Verzenio, but I try not to think ahead too far. Good wishes to you!!

BeautifulSunset, this something I do not want to hear. You know, six months may be the average, but some of the treatments could work longer for you. And Y90 is entirely appropriate for diffuse liver mets. Add immunotherapy or other trials, and it adds up. F1 should check MSI to see if Keytruda is an option. Make sure you get sensitive Her2 testing, since Her2+ would open up a whole new kind of treatment, like it has for WoodyLB. Maybe this is a good time of for a second opinion just to get a fresh look and maybe new ideas.

SchnauzerMom- I am so glad that you are getting a good result with Abemaciclib so far! your treatment history is impressive. Very interesting that you got 13 months on Tamoxifen.

Did you get 2 years of good results from Aromasin/Affinitor 7/14-7/16 before you changed to Xeloda? That is impressive - how did that go?

Have you had a Foundation 1?

ABeautifulSunset, Guardant can provide some valuable information but if you do not see any actionable results from the liquid biopsy, I would consider pushing for Foundation One or Caris test. I mistakenly did the Guardant liquid biopsy when I was on Abraxane and it was working. My results showed zero mutations/amplifications/alterations. However, before the liquid biopsy and after the liquid biopsy, I had Foundation One tests (one on a supraclavical lymph node and the other on a liver tumor) and both showed a treasure trove of mutations and alterations. I just started an FGFR inhibitor through the NCI MATCH trial a few days ago. The trial looks for any types of solid tumors (regardless of what type of cancer) with certain mutations in a whole bunch of different "baskets" testing different medications. Due to having an FGFR1 amplification on my F1 report, I qualified for this trial. The NCI MATCH trial does not have limitations for heavily pretreated patients and there are few qualifications to be accepted other than having an actionable alteration in one of their baskets. The drug I am taking, erdafitinib, is currently pending FDA approval for urothelial (bladder) cancer as it has demonstrated a good results in those trials.

Y90 is also a good option for you. It is the first thing that has made me feel like I am not chasing down my liver mets from behind. All of the treated lesions have remained inactive. However, Y90 only treats active tumors (that are highjacking the liver's blood supply). Tumors that are inactive or in remission at the time of Y90 will not be treated and may grow later. I have had a few small tumors grow since Y90 - tumors that were not present at the time of the Y90 but were present at other times in the past - but on a much smaller scale than my typical progression. My MO mentioned that I could do a second Y90. Apparently, in colon cancer, Y90 is sometimes done 3 or so times.

Sunset, I think I understand. Ideas, advice and encouragement can be good. But sometimes what a person needs is simply for friends to stand beside them and agree that the situation is scary and depressing, and that chemo is hard. I am sad to see my friend going through this and I am worried about you. Basically it sucks.

Janey,

Please re-post your note on the liver mets thread, where you will get tons of help and support!

https://community.breastcancer.org/forum/8/topics/...

Also it would help to mention more about your mom's condition, especially did she get a new biopsy on the liver mets when they were discovered? It is important to make sure the cancer remains ER-positive, and since it has obviously mutated, has sequencing been done to learn what are the mutations that may be driving the cancer growth at this point? In addition, has she had a second opinion for what to do next, and is she being seen by an oncologist who specializes in breast cancer, at a major NCI center if possible? It does not sound like she has had clinical trials as yet? The more information you can provide on her case, the more specific the responses will be- Good luck!!