Using Ibrance again after intervening treatments

Thanks, Bev...My trial appears to be going well. I am just about to finish my first trial cycle; my CA27-29 has been stable over the past few weeks, but my CA125 has dropped by about 25%...

It seems that no one else is re-visiting Ibrance, or at least no one is responding to my query. But I'm thinking that this can't be the only trial that is looking at using a CDK4/6i after prior exposure. There seem to be so many new targeted drugs in trials, and so many mets patients previously on a CDK4/6i that you would think that some of them would try a new combination.

I'll keep checking back periodically to see if there's anyone new posting.

And I hope you keep on doing well with your first use of it. I know there are some people who have had more than 4 years on it. May you surpass their records!

Elizabeth

Hi, Moissy-

Thanks for posting about your experience. I'll be following your updates closely to see how you respond. Did you have any intervening treatment after fulvestrant and Ibrance before starting on your trial? If so, can I ask what and for how long? And do you have an FGFR mutation? What prompted you to try this trial?

I'm pretty surprised that my ANC stayed as high as it did and that my platelets dropped so significantly. I'm really curious to see what the values are at the end of my week off, and into the first week back on palbo (seeing that it has a 30 hour half-life and it's impact can continue through some or all of the week off...). I guess there is something positive that comes out fo the weekly visits during the early months of my trial!

Here's to good trial outcomes for us both, and for everyone else-- from whatever treatment you are currently on.

Be happy today.

Elizabeth

Moissy-

Well, I am starting cycle two, still on 125mg.

After 6 days off, my ANC is 2.6 and my platelets are up to a whopping 165K (from 144K at the start of the trial 4 weeks ago, and 112K 6 days ago.) Go figure. Will be very curious about how this cycle goes (My and was 3.6 at the start of the trial, so not quite a full recovery...)

Keep us updated on how you do with the FGFRi and re-visiting Ibrance...I hope you get a fantastic, durable, tolerable response.

I am still getting labs every week throughC2, then (if I get to stay on trial) it drops to every other week. It will be so nice to not have to drive 7 hours to/from Seattle just for a blood draw every week!!

Hello, all...This was cross-posted in the "Clinical Trials" thread....

Well, for me at least, the SERD plus palbo trial was a bust.

I had my 2 month CT scan yesterday, and despite the fact that SCCA won't release the scan before your appointment with the onc (scheduled for this Monday), I got the results last night.

My local onc scrounged around in her patient portal for me and sent me the report last night. Unfortunately, it shows that there is more ascites, thicker stranding in the omentum, slight growth in the bladder lesion and two new lesions in my lung...I've not had lung mets before, so that is a bit of a shock. They are 1.2 cm and 6mm in the longest diameter, but appeared in two months, so are significant. I have not been sick, and unlike a few years ago when I had two odd-shaped lung lesions appear, these are ovoid and look like metastases....the ones in January and April 2018 were very oddly-shaped and the radiologist noted "not typical in appearance." Those disappeared over 6 weeks when I was off drugs waiting to get onto a trial. One of the lung lesions was going to be my "measurable disease" for the trial, so when my start of trial scan showed them resolved, the trial was off. But I was never so happy to fail to meet inclusion criteria! These look more like cancer...I'm going to see about a biopsy (I'm wondering if my HER2 equivocal disease--2+ on IHC but ISH negative-- might be driving this more than the ESR1 mutation) but they might not be in an easy to access place, and even at 1.2 cm, might be too small. I know the 6mm one is.

So I imagine I am off the trial. I will learn my fate officially Monday morning. I am so thankful that my onc understands my preference to know the scan results prior to our appointment so that I don't feel blindsided and can come to an appointment with some well-though-out questions rather than spend our appointment time digesting the news. She worked behind the scenes late on a Friday afternoon to find the results for me. The trial is at a different cancer center, in a different state, and they are not on the same EHR system that her clinic uses, so it took a bit of work. She's caring and thoughtful like that, and I am so grateful to have her as my usual doctor. Se will be at SABCS next week (I won't--ugh) and says she will be on the lookout for some new ideas for me.

I'm sad. I'm scared. I don't know how to tell my 16 year old daughter that yet another treatment was ineffective. But it won't be tonight-- tonight she and her best friend of 10 years and I are going for our annual outing to have a nice dinner and see the Nutcracker. This is our 8th year in a row for that. So this morning the three of us will decorate our tree, do a little Christmas shopping this afternoon and then enjoy our annual outing.

I might just try for one of the HER2 low drugs next. My local cancer center is just starting a phase 1 trial for HER2 expressing solid tumors using A166...I'd really like to get into the DESTINY trial, but that's phase 3 and I could be randomized to the "standard of care" chemo only arm. There's no crossover to DS-8201 if there's progression on chemo, so it's not quite as appealing. I'm open to thoughts and suggestions from any of you smart, innovative thinkers!

I hope you all are feeling well, and finding happiness and joy in this holiday season.

Peace...

Elizabeth