Herceptin only AFTER Chemo?

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Tucheta
Tucheta Member Posts: 51
edited June 2014 in HER2+ (Positive) Breast Cancer

Hi

I was diagnosed in January 2008 (details in the signature below) and got my FISH test results (positive) after the first chemo session. My oncologist said there is no hurry to start treatment with Herceptin so I did 4 x chemo (taxotere +  farmorubicin), had mastectomy in May and started chemo again in June.

As far as I understood, I will start Herceptin only after I have finished with chemo, maybe even after radiotherapy too. 

From what I've read on the net, for patients with stage IIIb and positive lymph nodes, Herceptin is usually administered SIMULTANEOUSLY with chemotherapy, and then treatment is continued with Herceptine only.

I am a little concerned about waiting for another 4 month, to get Herceptin. 

So my question is if there is anybody else who has or had a similar treatment scheme: chemotherapy first and Herceptin alone afterwards.   

Thank you! 

  

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  • maryannecb
    maryannecb Member Posts: 1,453
    edited July 2008

    I had surgery first, then 4FAC then 4Taxotere/Herceptin, then completed the year of herceptin. My oncologist had originaaly planned the Herceptin after the taxotere but I presenrted him with evidence( did a search and found a study , don't have it anymore though) that rtaes are better when herceptin is given with chemo. he read the article and changed his mind. It is now given that way to others in our cancer centre.

    We have almost identical pathology...except m tumor was 9cm. I am still NED abd back in full swing. Good luck with the rest of your treatments.

    Fists up!

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  • mke
    mke Member Posts: 584
    edited July 2008

    I had 4 dd AC and 4 DD taxol, surgery and then radiation and herceptin.

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  • TammyLou
    TammyLou Member Posts: 740
    edited July 2008

    I have seen many women report that they did 4 cycles of anthracycline.

    THEN, 4 cycles of taxol with concurrent herceptin.  (Total 52 weeks Herceptin)

    I took Herceptin before there was a "consistent" protocol.  Studies found that Herceptin is not best combined with anthracyclines (AC, FEC) because of increased potential for heart damage.

    I took Herceptin concurrently with Taxotere, then FEC.  (As one of the original MD Anderson trials).

    I think they're still "tinkering;" however, it does seem that Herceptin is more effective with chemo than as a stand alone treatment.

    Tammy Lou

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  • TammyLou
    TammyLou Member Posts: 740
    edited July 2008

    http://professional.cancerconsultants.com/oncology_main_news.aspx?id=34511

    Comments: Up front Herceptin combined with Taxotere was clearly superior to Taxotere alone. However, for those crossed over to Herceptin (added it after taxotere) overall survival was approximately the same as for upfront treatment. However, it would appear that earlier use might be a preferable strategy.

    http://www.breast-cancer-treatment.org/metastatic-survival-doubled.htm

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  • Tucheta
    Tucheta Member Posts: 51
    edited July 2008

    Thank you, maryannecb! It's great to talk to... someone almost identical :-)

    Will do some more research and see if my doctor accepts suggestions

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  • lisettemac
    lisettemac Member Posts: 213
    edited July 2008

    I did exactly what Tammylou mentioned -- 4 rounds of AC and then 4 rounds of Taxol with Herceptin.  At that point, the Herceptin was weekly.  When I finished the Taxol, it became a 3-week dose.  Hope this helps.

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  • TammyLou
    TammyLou Member Posts: 740
    edited July 2008

    farmorubicin is an anthracycline

    It is unlikely that your onc will be willing to give herceptin WITH the anthracycline (because of the higher risk of heart damage.)  You may need to drop the anthracycline and go with the taxotere (or some other agent) to combine with the Herceptin.

    Tammy Lou

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  • Brenda_R
    Brenda_R Member Posts: 509
    edited July 2008

    Stage III Her2positive, I had surgery, then chemo (A/C), then rads, then 1 year of Herceptin alone. No added chemo with the Herceptin.

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  • Tucheta
    Tucheta Member Posts: 51
    edited July 2008

    Thank you all for your kind responses! This forum is a true blessing.

    In the meantime I had TammyLou's opinion confirmed by a doctor: no Herceptin while on AC, due to increased cardiovascular risk! So I will finish chemo and rads, and then start Herceptin.

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  • BMac
    BMac Member Posts: 650
    edited July 2008

    Just putting in my two cents.  I did 3 FEC then 3 Taxotare which is when I started Herceptin.  Next was surgery (bi-lat mast) and just completed rads yesterday.  Herceptin continues until January.

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  • Yogi70
    Yogi70 Member Posts: 654
    edited July 2008

    Hi,

    I had surgery then I did 4 dd A/C and am currently doing Taxol/Herceptin weekly.  I have four more Taxol tx then rads.  I will continue doing herceptin weekly.

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  • Estepp
    Estepp Member Posts: 6,416
    edited July 2008

    Did any of you who did the rads last ( as I am going to do) have implant reconstruction before rads?

    TY

    Laura

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  • Yogi70
    Yogi70 Member Posts: 654
    edited July 2008

    I probably won't have recon. surgery until next spring but (and I'm sure someone else will chime in) I would think you would want to wait unit after radiation because you want your skin to be healed.  Just my thoughts.

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  • Tucheta
    Tucheta Member Posts: 51
    edited July 2008

    I agree with Yogi. I was also told the reason why I cannot have immediate reconstruction is that I will have to do rads and wait until the skin is healed.

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  • BMac
    BMac Member Posts: 650
    edited July 2008

    Ditto, no recon until after rads; apparently they can't radiate implants.  I go for consultation on August 7th.

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