TRIPLE POSITIVE GROUP

HapB - Perjeta doesn't necessarily have more side effects, but they are very similar to the side effects of Herceptin. For some patients who have both drugs simultaneously, the SE are more pronounced because the similar SE are compounded. On the other hand, other than some GI issues and a runny nose most don't have too many issues with either, or both, targeted therapy drugs. An equivocal Her2 result means not negative enough or positive enough to make a treatment decision. Reflex testing to make a better determination (your subsequent FISH), is done and you are barely over the line that is considered a positive result - your docs are advocating Herceptin to be on the safe side and because there is thought to be use in prescribing Herceptin even for those who are lower expressing Her2 patients.

kae - I think there are a few who managed to get this approved, but they may have been particularly high risk patients, or those who did not achieve good results with neoadjuvent treatment. Until the FDA blesses Perjeta adjuvently your insurance company has discretion to disapprove your MO's request. Unfortunately, a lot of this stuff comes down to timing.

specialK, my tumor is not palpable anymore but recent MRI showed 50% reduction. 2 more cycles to go. both my MO and BS cannot feel the lump anymore.My MO said hopefully those showing on mRI are inactive cells. that is why i want Perjeta to continue as an added insurance if i dont get pCR.Soxfan75, has your MO put in a request for continuing Perjeta already?

SpecialK, I looked at your link, I am confused, I wonder if there's a possibility he misspoke, I even repeated what he said to me. What should I do next? Wait till I go in next time and ask again and then question him with a printout of the link or call them tomorrow?

Soxfan, I appreciate your post as well, they will have to explain to me what is what....maybe they did swithc it. I feel so ignorant about all of this, there is so very much information to read and re-read. The more I read the more insane it all sounds.

HapB. That is the regimen my first ONCO gave me. I have to re-verify what the second said to me.

Upheld. Here's to hoping that they know what they're doing!

Moodyblues, I've seen a few regimens. The one I've seen the most is Taxotere, Carboplatin and Herceptin (+Perjeta) every two weeks (sometimes three weeks) given neoadjuvant. The other is Taxol and Herceptin (+Perjeta) weekly with Herceptin given every three weeks during and after Taxol. That was the second chemo regimen I was given. TCH(P) usually includes Taxotere but maybe your MO decided that Taxotere would be too harsh. Maybe I missed it but what was the chemo treatment your new MO said you would receive?

Perjeta was approved in 2013 for early stage women. FDA approved it to be given neoadjuvant and for tumors larger than 2 cm.

HapB - I also received it post bmx and my MO got approval from the insurance company before we went ahead with it.

habp,

The abstract from the APHINITY study is coming out next Wednesday, May 17 at 5 PM. If it is positive, perhaps your oncologist can use whatever data is made public to advance your case with your insurer. When Herceptin was first developed, it was only made available to patients with larger tumors. It was then realized that there was no "biologic reason" for Herceptin to be denied to those with smaller tumors. Watch out for the APHINITY abstract next week. Full study should be published June 6.

Updated to add: The APHINITYabstract will be posted online at 7:30 a.m. (ET) on Monday, June 5.

Soxfan75, do you have HMO or PPO insurance?im glad Perjeta was approved for you in the adjuvant setting. are you only getting it for 6 times? along with Carboplatin,herceptin and taxotere?

I just wanted to say thank you for all of you and the information that you shared with me. I haven't even started chemo yet and am feeling a bit melancholy. I sailed through the BX, the MX and the drain tubes, but am feeling so down right about now. I see from previous posts that I WIILL be okay AND I WILL get through this with support. Thank you!!!

CoachVicky. As always, thank you. I think I will do that. I am so used to being in control and having a schedule or routine everyday, now there is none of that....maybe 'that' is the reason for me feeling a bit out of sorts. I think what I am dreading the most is the sleeplessness, weight gain, and swelling. Many women base their self worth on how good or sh*tty (excuse my language please) they look on any given day, I thought that I was not in that group and now realize I am. I am intelligent and I know that I have more to offer than my looks, but now I am doubting everything about me.

kae_md99 – My insurance is a Fee For Service (FFS) with a PPO. The plan for now is to get it with each chemo treatment of TCH, so yes, 6 times. At some point, my onc is going to push my insurance company to cover it for the entire year that I'm getting Herceptin.

Moody, I've never seen Taxotere/Taxol, Carboplatin and Herceptin given weekly. It's usually every two weeks (sometimes three) for 6-8 treatments. The regimen that is given weekly for twelve weeks is usually Taxol and Herceptin.

I received Benadryl with my infusions too. They made me a little sleepy but I felt fine by the time I had to leave. They give you the Benadryl to help counteract any allergic reaction you would have to the treatment.

Hmm... Well, PET scans are notorious for producing false positives. Three PET scans showed "something" on my left femoral neck (hip). However, it never showed up in a CT scan or an MRI. So, my oncologist considers that to have been a false positive.

I did get a "before" PET scan and an "after" PET scan. The latter showed that the chemo worked! It showed that the active cancer was gone from my breast and compromised node. It gave me the confidence to get a lumpectomy rather than a mastectomy.

I would do the chemo, and hope that the second PET scan shows that it has worked. ((Hugs))

kae,

I don't think that timing necessarily matters. Just make sure that the radiologist knows about all the various surgeries and injuries you've endured because they might light up. For example, the site of my port insertion lit up.