A New Starting Point for Stage 4 HER2 Breast Cancer

The American Society of Clinical Oncology released new guidelines for the treatment of stage 4 HER2 positive breast cancer according to recent news.

In the guidelines, the first line is the three-drug combo of Herceptin,Perjeta, and  a conventional chemo drug, and the 2nd is T-DM1.

When Perjeta was approved in 2012 as a new antibody drug that targets only cancer cells  just like Herceptin, the FDA recommendedTaxotere as the additional conventional chemo drug. However, a recent clinical trial showed that weekly Taxol had a better result thanTaxotere, which was given every three weeks.  Based on this study, many oncologists are recommending Taxol instead of Taxotere.

Because Taxotere and Taxol are both Taxane agents, when Taxoterefailed to suppress my cancer, nobody wanted to recommend Taxol.  Yet, as I chose Taxol, being convinced by Dr. M in Japan whom I became a friends with through this blog, the drug (along with Herceptin and Tykerb) wiped out the metastasized cancer in mediastinal lymph nodes promptly and carried me to remission.  It was too bad that Taxol damaged my peripheral nerve system, but other than that the side effects were much less than Taxotere in my experience.

I do not understand and am curious why T-DM1, the drug people touted as a miracle medicine, is the 2nd choice.  Maybe price also plays as a part besides effectiveness and side effects, since T-DM1is more expensive than Perjeta.

I, who have used both Perjeta and T-DM1, am interested in the 3rd line, yet the guideline just says Herceptin or Tykerb  with chemotherapy.

In another site I found that there is a 3rd phase clinical trial going on, in which a regimen of Herceptin and Navelbine with a kidney cancer drug, Afinitor/Everolimus, improved the remission period.   Afinitorhas been already used for hormone positive breast cancer and hasperovided effective evidence.

As I haave tried Herceptin + Navelbine – the regimen didn’t work-  unfortunately this new regimen doesn’t look good to me, either, but I saw that this combo has an excellent result somewhere, so  for patients who haven’t tried Nevelbine yet, probably it is worthwhile to try it.

My next CT will be 6/4.  Since thelast scan showed some findings, this coming CT is important to see how things have changed.  Researching new regimens, I am praying for the good result.



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