MD Anderson protocol her2 metastatic

Yes,treatment is for life. If you failed Herceptin, you might start with Kadcyla. Getting a port is up to you and your doctor. I’m on IV meds but I never had a port

Ngj, I was diagnosed stage IV de novo and HER2+ with bone mets in November 2016 and have been treated at MDA since then.

Question, how you you know Herceptin failed? Did you have progression while on it or after the typical one year following initial chemo?

If Herceptin truly failed, I think TDM1 might be next, and yes anti HER2 infusions are likely every 3 weeks for as long as they work. I had a port from the beginning and I’m pleased with it. It’s been nearly 5 years and it’s easy, painless and saved my veins from so much poking.

Ngj, interesting situation (from a medical perspective) but I’m sorry you’re going through it. Since your initial chemo did not provide a complete response per later pathology but you didn’t actually have progression until years later after systemic treatment had been completed, they may suggest H&P again or could opt to move directly to a 2nd line of treatment. Good luck Friday and if you feel like sharing the plan they come up with, I am interested in hearing about it.

I'm sorry to hear about the situation you're dealing with, but the good news is that for HER2+, hormone receptor negative MBC there are many options. With bone mets, you should be placed on a bone-directed therapy such as Zometa or Xgeva. And below from my book, "The Insider's Guide to Metastatic Breast Cancer" which is also available as a complimentary .pdf is a list of FDA-approved MBC treatments for your disease subtype. For more information please visit https://www.insidersguidembc.comI'd also suggest obtaining a second opinion.

I hope you respond well to your next treatment!

First Line Treatment:

• A "triplet" combination of Herceptin (Trastuzumab) (or an approved biosimilar, or a subcutaneous injection called Herceptin-Hylecta) along with Perjeta (Pertuzumab) and a Taxane chemotherapy is recommended for first-line treatment unless you have congestive heart failure or significantly compromised left ventricular ejection fraction (since Herceptin and Perjeta can cause heart damage).* Alternatively, Phesgo (an injectable combination of Herceptin, Perjeta, and hyaluronidase-zzxf) can be given with a Taxane.

Second Line Treatment:

• Kadcyla (TDM-1/Ado-trastuzumab emtansine) alone. This is the recommended second-line treatment.

• Tukysa (Tucatinib) with Xeloda (capecitabine) and Herceptin (or Herceptin Hylecta or a biosimilar) is another option (approved for HER2 positive MBC patients - including those with brain metastases - who have received 1 or more HER2-directed therapies in the metastatic setting).

Third-and Later-Line Treatment Options depend upon what treatments you've previously taken:

• A third- (or later-) line treatment is Enhertu (Trastuzumab Deruxtecan/DS-8201), which was FDA-approved in Dec. 2019 for HER2-positive MBC patients who have received two or more prior anti-HER2 based regimens in the metastatic setting.

• Another third- (or later-) line treatment is the combination of Nerlynx (Neratinib) plus Xeloda (capecitabine), which has been FDA-approved in Feb. 2020 for HER2-positive MBC patients who have received two or more prior anti-HER2 based regimens in the metastatic setting.

• Another option is Margenza (Margetuximab) in combination with chemotherapy for HER2-positive MBC patients who have received two or more prior anti-HER2 regimens, at least one of which was for metastatic disease.

Other options include:

• Herceptin (or Herceptin Hylecta or a biosimilar) and Perjeta, with or without chemotherapy (if the patient has previously taken Herceptin and chemotherapy without Perjeta). Alternatively, Phesgo, an injectable combination of Herceptin, Perjeta, and hyaluronidase-zzxf, can be given with or without chemotherapy.

• Herceptin (or Herceptin Hylecta or a biosimilar) with chemotherapy.

• Herceptin (or Herceptin Hylecta or a biosimilar) with Tykerb (Lapatinib).

• Tykerb with chemotherapy.

• A clinical trial.

Ngj, sending you good vibes for an easy and long run on this medication.

Here's a link to a discussion of Kadcyla... https://community.breastcancer.org/forum/69/topics/880191?page=1#top