Fill Out Your Profile to share more about you. Learn more...

Verzenio/Letrozole to Xeloda?

Curious whether anyone else has had Xeloda as second line monotherapy after the Verzenio/Letrozole combo? 18 months on that but suddenly many more bone mets/lesions grown bigger so switch has been recommended by onc.

Comments

  • emiliamarty
    emiliamarty Member Posts: 21

    I don’t think I have many unaffected vertebrae left

  • cure-ious
    cure-ious Member Posts: 2,705
    edited January 21

    If the goal is to enhance overall survival, most regimens try to delay the time to chemotherapy (TTC) in order to get the most benefit out of endocrine therapy for ER-positive MBC. Have you had genomic testing to learn why the cancer is not responding to Verzenio-Letrozole? For example, if the cancer has developed an ESR1 mutation, that can be readily reversed with an oral SERD such as Elascestrant or lasofoxifene, oral SERDs or PROTACS currently in clinical trials.

  • emiliamarty
    emiliamarty Member Posts: 21

    Thank you. I will take these questions to her. I understood her to be recommending a break from hormonal treatments before a return to a different combination, with Xeloda as a temporary fix. It responded superbly to Verzenio-Letrozole in the first 9-12 months - at one point complete metabolic response - and then tapered and, most recently, an accelerated decline. Various alternatives were raised should I have DPD deficiency, including Piqray and Afinitor in combo with fulvestrant or exemastane but Xeloda was her first choice.

  • cure-ious
    cure-ious Member Posts: 2,705

    Always worth the time to get all the data and go for a second opinion, especially right at the start, and with so many new drugs out there. Another issue is how many bone mets are heating up, when I first had bone mets start to light up they decided to radiate three areas ( two on spine plus a smouldering mass of hip mets that were getting hotter with each scan), which got me another 1.5 year on the same therapy. Just suggesting to look at all the options

  • emiliamarty
    emiliamarty Member Posts: 21

    Thanks. Spine like a chain of Christmas tree lights, 11 new ones since October, the old ones also glowing brightly now.