Tuesday, April 29, 2008

chemo, part II

as with most 'chemo' days, we met with dr. carlson and dr. telli on tuesday.
dr. carlson finally received the results of trish's her-2 test (a test that was supposedly ordered by PAMF the week of April 7th.)

the results of the her-2/neu test are positive, which means there will be a change in the chemo recipe and schedule. this is the same course of treatment trish would have began had the test results returned sooner.

trish finished up her "1B" cycle of CAF chemo yesterday (only took 1 nurse 2 attempts to find a vein), and will continue with her cytoxan pills for the next 7 days. she will still have 14 days of no pills/ivs/doctors/chemo/etc.. but beginning may 20th, her regimen will change.

trish will begin on the drugs taxol (paclitaxel) and herceptin (trastuzumab) by IV, once a week for 12 weeks.

when this course is completed, she will switch from 'CAF' to 'FEC' chemo every 21 days for 3 cycles. the cytoxan will now be administered by IV, rather than the 3-4 pills trish currently takes for 14 days. (this is good for trish)

5 fluorouracil (5-FU)
epirubicin (Ellence)
cyclophosphomide (Cytoxan)

dr. carlson recommended the herceptin/taxol followed by 'FEC' regimen based on the conclusion of the Buzdar study at MD Anderson:

"Presenting the findings at the American Society of Clinical Oncology (ASCO) meeting, Aman Buzdar, M.D., professor in the Department of Breast Medical Oncology at M. D. Anderson, reported that more than 65 percent of early stage, HER-2 positive patients experienced a complete response rate after receiving Herceptin with chemotherapy compared to 26 percent of patients with similar tumor types who received chemotherapy only.

Buzdar said that because the results were so striking, the Phase III trial was halted early after accrual of 42 of the originally planned 164 patients. After reviewing results of 42 patients and finding the overwhelming increase in complete response, Buzdar and his team stopped and revised the trial so that all M. D. Anderson patients newly diagnosed with early stage, HER-2 positive tumors receive Herceptin plus chemotherapy prior to surgery. "

when this course is completed, trish will continue on herceptin alone every 3 weeks for a 12 month duration
it will be during this time that surgery will be scheduled.

trish is still feeling pretty much the same as the weekend... little nausea here and there, but nothing too bad..


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