Topic: What is the difference between HER2+ & HER+++?

The +++ means grade 3 - the most aggressive. I guess ++ means grade 2.

 Mine was grade 3.

 First TCH treatment today - wish me luck

Frankie,

 I'm sorry the +++ does not mean grade 3. The +++ is the expression of the gene. +++ is still more aggressive than ++

First treatment went well so far - give me 48 hours and I might change my mind. The onc didn't give Herceptin for the first treatment so he could distinguish which drug causes an allergic reaction if any.

Some ladies just use her2+ to signify her2 positive. Some go farther and put +++ to signify that they scored strongly positive. I've used both as mine scored +3, strongly positive. Mainly I just use Her2+ to signify positive instead of her2-. 

One of the tests for the HER2 receptor, IHC, gives scores of 0, 1, 2 or 3 depending on how much overexpression of the HER2 receptor is. The score of 3 is sometimes written HER2+++. If the test produces a score of 3, they say your are HER2 positive and that is also often written HER2+ so they mean the same thing which is rather confusing.

If the score on that test is 2, your HER2 status is indeterminate and they can do another test called FISH which is suppose to be more accurate/less subjective to find out if you are HER2+. Some places just do the FISH test first. 

Hey SuePen.

Sorry to hear you're having a rough time.  Are your treatments every 3 weeks or every week?  What prescription are you thinking of trying for next time to help with the aches?  I read about taking Aleve before TCH and right after to help with muscle/bone/joint pain.

 At least chocolate still tastes good ;)

Hang in there, I hope you find the right mix of scripts to help you through the next treatment.   And I hope you feel good enough to enjoy your Thanksgiving!

 Sue

Suepen, after reading about it somewhere on these boards, I realized that the reason I was falling into an emotional abyss after each TCH tx was because I was going off the steroids too quickly. I needed to be weaned off much more slowly. This made a HUGE difference for me for my last few TCH txs. Ask your onc. to wean you off the steroids more slowly. I don't think the docs really have a clue how much the steroids effect us.

Best to you all starting tx now. You'll make it through. 

Hi Cowgirl,

I honestly don't remember the schedule. I think they had me off the steroids by 3 days after tx. I just asked to taper off more slowly. I think I was also reducing the dosage so that rather than just taking it for 3 days after chemo and going off cold turkey, I took less each day and maybe finished it by 5 days after chemo. I finished chemo 2 years ago, so I'm sorry I can't be more specific. But I can tell you it made all the difference for me--that emotional abyss was very deep, and that was WHILE I was taking antidepressants. 

Hey SuePen,

 So far I've had only the "run-in" dose of herceptin and tykerb (part of the trial protocol).  I'm tolerating both of those pretty well.  The chemo part (TC added to herceptin and tykerb) begins 17 Dec.  I had the port put in this week - ouch!  But I bet I'll be glad I have it.

I'm glad you finally feel normal again.  I've got the same protocol you do with the steriods, I take them 2x a day on the day before and the day after treatment.

When is your second treatment?  Coming up soon?  Best of luck!

Sue

Hey Sue - my trial is called "Trio-B07".  There are 3 treatment arms:  TCH, TCH + Tykerb (chemical name lapatinib) and TC+Tykerb.  The treatment is neo-adjuvant, 6 cycles separated by 3 weeks.  At the end of treatment, surgery 4 weeks after the last chemo, then herceptin for the rest of the year.

I was excited to try it because Tykerb has been shown to cross the blood brain barrier, which Herceptin won't.  Also, it attacks the HER-2+ aspect from the inside of the cell, Herceptin works from the outside of the cell, and I liked the visual of the cells being attacked on 2 fronts.  I'm in the TCH+Tykerb arm, so I figured I was getting "standard of care" plus a bonus :)  Tykerb is already used for Stage IV patients, this trial to to see how it does in a neo-adjuvant setting in earlier stage patients.

Where in Australia are you?  I've visited 2x, both times to Queensland, and loved it.  It would be great to go back and see more, it's such a huge country!

Best,

Sue