Although I still have a cough and a sore throat, my blood test result was good enough to receive T-DM1. My appointment was supposed to be at 11:30 am, but a phone call came to moved it up to 11:am. Being asked by a nurse over the phone, “ Are you excited?” I answered, “Yes!”
At a chemo ward, I had to take Decadron, a steroid, on top of Tylenol and Zyrtec as pre-medications. Because I am the first patient for T-DM1 in the hospital, this unexpected addition made me nervous and I asked repeatedly if this steroid was really necessary. She said ‘yes’ repeatedly as well looking at my chart in a computer and then told me if anything strange happens, such as a shortness of breath, or even back-ache, I should let the nurses know by pressing a buzzer.
Infusion started from a bag of Sodium, as usual, followed by T-DM1. Just 10 or 15 minutes after T-DM1 started, my hands and feet were tingling and numb. It didn’t hurt, but following the instruction, I called a nurse. He changed the tube of the I.V. from a white one to a blue one. How does it help my tingling and numbing? I wondered. (In fact, It didn’t help at all. ) Then I got sleepy and slept soundly until everything was over.
As of now, at the end of the day, I feel a little tired, and still feel a little tingling on the tips of my fingers, but other than that, I am fine. As of day 1, this is pretty good!
Scientists Identified Who Get the Benefit Most from T-DM1
According to an article I read a few days ago, Emilia, the 3rd phase clinical trial gave data indicating that T-DM1 was most effective for women whose HER2 level was higher than its median. Although all participants in the Emilia trial were diagnosed with HER2 positive, the HER2 level, which is considered by the amount of HER2 mRNA( a cancer messenger), differs from patient to patient. Also, even if a patient’s gene, called PIK3CA was mutated, unlike Herceptin, which was not effective for those cases, T-DM1 didn’t affect any progress-free survival rate. In other words, T-DM1 may work even if Herceptin was not working, and someone like me, whose cancer was so resilient, may have higher amount of mRNA of HER2, and if so, there is a good chance to get benefit from T-DM1.
Regarding the side effects, they usually show up after a few weeks or cycles, so I am on guard, but hopefully I can share a good report for many women who will need T-DM1 and many people who have rejoiced for me getting T-DM1!