Shadow in chest is recurrence
Comments
-
watching this
Now she is clearly involved with abemaciclib... but the stuff coming out of Monarch trials is very encouraging
0 -
Ioana - I have been following abemaciclib trials with zeal, but what is the checkpoint inhibitor she is referring to being paired with it? I want to discuss all options with my onc in November. MONARCH 1 appears promising for those who failed on Ibrance, but what response rate is she referring to at 20%? Please help. And many thanks! I owe you a glass of something. Z emailed me from Japan, she is finishing up her "heated" liver, followed by Japanese xeloda and low dose gemazar, along with immumotherapy. If successful she will maintain on faslodex or fas+ arimidex. Rooting for all of us to have more choices!
xxx
0 -
I’m also watching Abemaciclib with great interest. In fact, I intend to discuss strategy with my MO in November regarding what is next if the Anastrozole fails as I waould like to ensure that I am able to participate in a trial with Abemaciclib when it gets to Canada. Given this, I would probably choose Xeloda. I am not sure if they would define my experience with Palbociclib as a fail. We chose to stop that treatment as my blood didn’t like it much. The neutrophils were fine but my red blood cells refused to recover.
Claire, I believe the 20% response refers to the arm getting Abemaciclib alone who had progression after a number of hormonal and chemotherapy treatments. I’m not familiar with that check point Inhibitor- will need to do some research.
Off to try nine holes with the big clubs. Wish me luck
0 -
Hi guys
Are these drugs available to those who are both Her 2 positive and Er positive?
L
0 -
Liz - appears the newbie abemaciclib can handle both HER- and HER+. Take a look.
0 -
Claire and Pat,
Can't resist a good bottle. This what I know.
The study combining keytruda ( pembrolizumab check point inhibitor) with abemaciclib -
https://clinicaltrials.gov/ct2/show/NCT02779751
This the abstract from Monarch 1
https://www.ncbi.nlm.nih.gov/pubmed/28533223
The number are small 132 women but they look promising for oncology.
The objective response rate is the proportion of patientswith reduction in tumour burden of a predefined amount. For most IV chemo in the metastatic setting the number are often 10-15% ( I know ...). The 6 months progression free survival and 18 months median survival are also good numbers in this setting.
This group as you note from the selection criteria had multiple organ involvement, failed hormonal therapy and had been a about three lines of IV chemo - so heavily pretreated. The numbers may be better if used earlier on. Also abemaciclib was used as a single agent.
The BIG question is if you fail a CDK4/6/antihormonals and then have a great response to IV chemo - can you then go back to a CDK4/6 combo?? We know that chemo sensitises the tumour cells to the immune system ( hence the Z Japan drugs) - is it enough to get another good stretch out of a CDK drug?? Does it make a difference which one?? If that is true then we are truly starting to push the envelope into chronic disease.
Pat,
You know my thoughts. I think your chest had been mostly the cause of your anaemia ( I fear to say the drain part..) and under Ibrance your bone marrow did not want to recover. So my instinct is to say you still have Ibrance on your back pocket. I like an onc who will not be bluffed by fear of disease - he has the clinical advantage of knowing how tough you are and is willing to sit it out - rather then use his bullets. I have said it before really like your onc, not sure I would have the nerve - I threw the kitchen sink at my little shit - fully knowing my picking up the sink was fear driven.
So happy you are out and about.
Liz - you are always in our thoughts.
(())
😊
0 -
Ohh Liz,
Just caught up on the last two messages - yes it's starting to look like it - and that would be super super fantastic!!
😊
0 -
Thanks Ioana,
I appreciate you sending these clips. You know my feelings as well - I really like my MO. I believe the two of us are prepared to play “chicken” a bit. I am fortunate to have a slow progressing disease so don’t feel compelled to make hasty decisions. I recall when I suggested I was not responding to the Taxol and wondered about shifting to hormone treatment that he said “Yes, we have time.” I refuse to allow panic to cloud my thinking and appreciate an onc that appears to be on the same page. I’m going to stare this bugger down!
One of the questions I am pondering is the effectiveness of chemo with my slow, plodding disease. The fact that Taxol, the “go to” Taxane, failed me miserably is always at the back of my mind. Why? Is it because the cells are not rapidly dividing? Is this a predictor of success with future chemotherapy agents or are they variable in terms of their approach? More research for me here and some conversations with my MO.
On a final note, my nine holes, with the big clubs, went well. A bit of a challenge at times but overall, I am wondering if my swing is resulting in a stretch of those adhesions. I actually had some pretty good shots and, while at the beginning I thought this was the end of golf season for me, by the time I finished I decided that I would try “physio”at the driving range. You can’t blamea girl for trying. 😁
Hope you all have a great week!
0 -
did anyone notice the ' take the fright out of breast cancer' thread and Halloween campaign - not joking - ahhhhhhh, grhhhhh
0 -
I hadn't noticed that but are they serious? I love this forum but at times really question the sanity of the moderators....
0 -
Proposed BCO Halloween fundraiser.
Worth a look - between the big pharma agendas and the marketing campaigns...on this site and an active thread.
0 -
Hi Liz,
Hoping you are well - toast Tracey behind, and getting a little less tired with each passing day!
Pat,
I would love to know what your MO thinks of your chemo question.
I get the feeling it's VERY hard to really know. The tumours are too heterogenous to really tell what part responds and what does not - aside from TMs down, pt better, scans improved. Although work in that area is moving along...
A guy called Joseph Balsega from MSKCC talks well on it.
You see to begin with, in pathology when the slice the tumour and get their slides according to protocol - the tumour being heterogenous - it means when you get a grade - most cells are that grade but you probably have cells on both sides of the number - ie you will at a good size tumour even if graded 1 or 2 have some grade 3 cells around. And when you reoccur - again hard to know what " stem" ( there is a bit of work in that too and some of the circulating tumour cells tests sometimes comment on it - note Z reported one cell recently but a stem/ mother/aggressive little one) started it all and then what is the main components of the tumour. In that sense I don't think the Taxol was a complete waste - if anything nasty and aggressive was floating around, it might have got it - just not your main scannable disease.
The second is that within the taxanes there are some differences and then within the other chemo regimes wide differences in mechanism of action. So I am guessing if you need chemo in the future ( and I hope it will not be for a very long long time) you have about the same numbers in terms of expected response.
Finally I found this good - he makes me smile - but people that know this craft well they can deliver it without bullshit always do. I really liked the "tell your doctor you WAN to get well". 😊
Claire - the last treatments might be the toughest ?? - we are all thinking of you.
I have been following the Z liver biopsy story - a bit naughty - you see there is rarely "ample " tissue in a biopsy - so much show that grades can be shuffled between biopsy and main specimen and sometimes there is not enough spec to do all the receptor testing. So for Foundation one to say we will do the testing and then send the rest over is naive at best and naughty at worst - they pretty much knew when they looked at what they got it would not be enough....ahhh, bugger them. Independent my advice to get another pathologist to look at the slides - it is done very often - and slides can sometimes be sent internationally for a second opinion - it is not hugely expensive.
(()) to All
😊🌷
0 -
Hi All,
Now in the waiting game again. I had my scan on Thursday but have not heard from my MO yet. He likely doesn’t have the results yet - at least not the radiologist’s report. I didn’t think I was at all nervous but it’s amazing how the doubt creeps in. I always call it that little worm in my brain that whispers negatively thoughts. But I’m sure all will be well. Feeling super and seem to have the pain under control. Lots to do around the house this weekend so I hope the pain stays put!
Have a great weekend everyone.
Pat
0 -
Hi Pat,
Hate waiting - just as much as I really don't like having any kind of test...
Thinking of you all this week/end!!
😊
0 -
Liz, 😊
How are you going??
All travelling along down under. We had had some rain which after a few scorching days is super pleasant.
I have just done a 24 hour call - I book myself a hotel next to the hospital - which means no matter how crazy it gets I have the privilege of a leisurely morning breakfast overlooking a lovely garden before I face another day.
Got called to an epidural somewhat late and watched a baby boy being born instead - ahhhh...- the miracle of life and I have had the privilege of seeing a few - always makes me smile.
Off to see the day and chooks ...🐥🐥🐥
Check in when you can...
😊🌷
0 -
Hi Liz and Claire,
Also wondering how you are both doing. I’vebeen watching you a bit Claire through some of the threads (and am thrilled that you are eligible for Abemaciclib). But Liz, let us know how you are doing after the bug you were dealing with.
Ioana, thanks for the positive thoughts. I should hear from my MO in the next day or two but have no reason to believe that it will be anything ominous.
Spent the weekend trying to get things shifted so that the renovations can continue. Bit frustrating as things always go slower than I want or expect, particularly now. Ran into a bit of a snag in that I don’t have a phone jack in what will become my home office for the next few months. Gotta love old houses! The expectation now is a phone jack and cable hookup in every room. Not happening with my old girl!
Have a lovely week ladies. Pat
0 -
Ah... the rollercoaster. Just reached out to my onc re: bloodwork schedule. It was a good excuse to remind him I am here as I had not yet heard back from him on the CT scan I had last week. His answer was brief - just to tell me he has booked an appointment with me for Friday and that I should receive a call soon. Damn... that sounds ominous... His last email indicated that I would see him in November. Hopefully nothing but the ups and downs get "old" really fast.
Pat
0 -
hi Liz,
How are you??
Hoping you let us know how you are going soon 😊
Pat,
Appointments change all the time and some oncs ( mine being one of them) can be really distracted.
I would try and not read too much into it - I tried to suss out what the radiographer thought of my scans 😱and nada - I can pick a nuance from miles ahead in theatre but when it comes to me it's like I have blinkers on - everything is different.
(())
😊🌷🐣
0 -
Hi to all,
Have been busy preparing for a formal lesson observation on Thur.
The bug has seriously affected me but I go on. It has been nearly 2 weeks and I still have a cough and cold.
Pat- I am just the same in terms of reading things into scans. It is awful and I can only say you are in my thoughts.,
Will post again tomorrow.
Love and hugs,
Liz
0 -
Crossed fingers and toes for your ?excellent? scan report tomorrow Pat.
0 -
Go Liz on your formal presentation! You will do great and please sideline Ms. Sniper. assistant. oy I have more good news, my TM's dropped by 1/2 again. Seeing onc today as a bonus, but still planning chemo through end of December to get numbers as low as possible. Then planning to switch to abemaciclib or Xeloda which means I will be on a oral med when I visit the British Isles. Wee~ Big PET on 11/6 - which will tell more of the story. Wish me luck. Pat - rooting for your scans too. Ioana - how are you doing? Will toast us all with a little Chateau Miraval.
0 -
Happy to hear from you Claire - raising that glass right back at you!!
Gentle walking week/end to all.
Hope you get out to the golf course Pat
Liz - 😊😊
😊🌷🐣
0 -
Well, Anastrozole has officially failed. Starting Xeloda tomorrow but tonight???.... to heck with cancer. I’m enjoying a British Columbia Syrah.
I hope the lesson went well Liz. Thrilled to hear about the TMs Claire. That’s wonderful news.
Wishing you all a lovely weekend. Pat
0 -
Pat,
Gutted to hear your news.
I am deeply sorry.
I will PM you.
Ioana
0 -
I am sorry. One foot before the next Gurl.
0 -
Pat, I followed the Xeloda thread for a while when my TMs kept rising with Ibrance. There are quite a few ladies that have done very well for quite some time with the major side effect being hand and foot irritation which gets better with a low(er) dose. Hope you enjoyed your syrah!
0 -
Oh no Pat - what will your dose of X be? Be careful for HSF - there is a good Xeloda thread. Will PM you. Liz, Ioana and Cive sending warm wishes for good weekend. Reeling over Pat.
0 -
Pat
This might be too early to post this since you are just getting your just getting your head around starting Xeloda..
But if a biopsy gets on the discussion table at any point - functional testing makes sense.
Z experiences with Foundation and Carris make me a little weary - but I have no personal experience apart from what I read on this thread.
There is a guy - Victor Velculescu - John Hopkins - who works in liquid biopsies - circulating DNA.
Also Functional testing makes lots of sense - not sure how helpful it is - you would have to ask your oncologist but it's logical.
Here is a link from inspire ( Z is still Z there and there are a few good people that post - fighterm as mentioned being amongst them)
https://www.inspire.com/groups/ovarian-cancer/disc...
I hope you can open it but I will be able to check after I post. Follow Greg's comments.
It talks about functional testing - Dr Wiesenthal and Dr Nargourney labs being the two doing this ( I think n California) - samples can be sent internationally pretty easily these days - a bit of my breast ended up in Germany Pfizer under the Pallas trial where I am randomised to placebo.
(())
Ioana 🐣🐓🐔
0 -
Thanks Ioana. The link worked but the link in the thread to Weisenthal’s site did not. Will need to explore further. Of course, the trick in Canada is to get the biopsy. Something to discuss further.
One thing you may find of interest is a clinical try here called POG (personalized onco-genomics) which appears to be using many of the same principles. I believe they are still accepting patients but will need to discuss with my MO. It’s difficult for me to add a link through my IPad but you can look up POG BC Cancer Agency.
So much to think about....
Hugs. Pat
0 -
Pat - I did the Foundation genetics test - just a blood draw so it didn't hurt. Turned out I had nothing unique to attack, but you may have a genetic variant where there is a better med than Xeloda to go for. Just a thought. Agree with Ioana that a liver biopsy can help make sure they have the whole picture.
Many ladies get long runs on Xeloda. Z is in Japan doing her warrior meds - watching her like a hawk. Fighterm on Inspire is super savvy, as is Cure-ious and Husband11 on BCO. Sending a hug tonight. Claire
0
