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Topic: ER-, PR-, Her2+ Roll call

Forum: HER2+ (Positive) Breast Cancer —

Testing, treatment, side effects, and more.

Posted on: Apr 3, 2011 01:17AM

Nevo84 wrote:

Hello everyone

My mom was dx in November 2010. She is in her Chemo courses and only 2 sessions left. She is so well now and is very hopefull.My little niece makes her so happy and she is planning for the ceremony of her first birthday. Since she was dx I've explored in this site in different cathegories but sisters with this signature are few. So I decide to start a new thread in which we can call all   ER,PR-, HER+ gals and specially who survived for years. I hope we can make a group like triple positives and etc.

Dx 11/3/2010, IDC, 6cm+, Stage IIIA, Grade 3, 8/35 nodes, ER-/PR-, HER2+
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May 28, 2021 06:13AM MochiPie wrote:

Thank you, BSandra. I have asked my MO for her rationale. The flow chart seems to suggest it's one of two standard courses (lower left) to receive only Herceptin if you are ER negative. I have good insurance and I'm not concerned about cost and I'm not unwilling to take Perjeta. I guess it's more of a quality of life/side effects vs benefit concern for me. I'm 6 months into my year of Herceptin now (3 months PFC).

Dx 11/3/2020, IDC, Right, <1cm, Stage IA, Grade 3, 0/2 nodes, ER-/PR-, HER2+ (IHC) Surgery 11/10/2020 Lumpectomy: Right Chemotherapy 12/8/2020 Taxol (paclitaxel) Targeted Therapy 12/8/2020 Herceptin (trastuzumab) Radiation Therapy 3/21/2021 Whole-breast: Breast
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May 28, 2021 07:06AM Beesy_The_Other_One wrote:

MochiPie,

This may be old information as it comes from August of 2018, but at that time, a HER2+ tumor had to be 2 cm or Perjeta would not be included with TCH. At my biopsy, my tumor was 1.5 cm, and then measured 1.9 cm on physical examination at my first appointment less than two weeks later. My MO said that day we would do an MRI, because he felt it would push me over the line to receive Perjeta. The MRI measured it at 7 cm, and showed it as having invaded the nipple. Suddenly I qualified for Perjeta and radiation--and Nerlynx didn't seem like such a foolish idea, either. That said, after a pCR at surgery, my MO continued Herceptin only for the remainder of the year.

1997: Phyllodes, R breast. 2018: IDC, L breast. TCHP, BMX, Radiation, Nerlynx. Dx 8/20/2018, IDC, Left, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
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May 28, 2021 07:55AM - edited May 28, 2021 08:00AM by MochiPie

My MO clarified that since my tumor was 0.9cm the standard of care is Herceptin only, even with hormone negative Grade 3 status. I don't feel like it's necessarily foolish to exclude Perjeta. I'm curious about other stage 1A node negative ER- PR- HER2+ patients on here have had disease progression without Perjeta. I honestly feel like I'm getting the medicine I need to prevent recurrence, and I'm a pretty cyincal/skeptical person in general. I welcome any 'change my mind' conversations, please! What would you tell your MO if you were in my shoes and strongly felt that Perjeta was essential?

Dx 11/3/2020, IDC, Right, <1cm, Stage IA, Grade 3, 0/2 nodes, ER-/PR-, HER2+ (IHC) Surgery 11/10/2020 Lumpectomy: Right Chemotherapy 12/8/2020 Taxol (paclitaxel) Targeted Therapy 12/8/2020 Herceptin (trastuzumab) Radiation Therapy 3/21/2021 Whole-breast: Breast
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May 28, 2021 08:05AM MCBaker wrote:

MochiPie, I am in your boat (except I chose a mastectomy), and I did not hesitate turning down the Perjeta. I considered it to be a weight-loss drug, and much too expensive for that. I continue to lose weight, walking 3 miles a day with my dog.

Mary Dx 10/3/2018, DCIS, Right, 6cm+, Stage 0, Grade 3, ER-/PR- Surgery 11/15/2018 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement Dx 11/16/2018, IDC, Right, <1cm, Stage IA, Grade 1, 0/5 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 12/18/2018 Herceptin (trastuzumab) Chemotherapy 12/19/2018 Taxol (paclitaxel) Surgery 6/27/2019 Reconstruction (right): Fat grafting, Saline implant
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May 28, 2021 08:18AM MinusTwo wrote:

Basically - all of us can weigh in with what we did & what we personally believe. It still comes down to you and your oncologist making a decision together. We'd like to believe that these are our bodies and we are in total control, but it's rare that even the most educated of us has studied oncology or has the ability to keep up with the new things that come out every day. Yes - read & learn, but then have the discussion with your doc. Push for what you want, even be wiling to go for a second opinion if you have doubts about his or her advice. But in the end, each of us has to make choices based on our own understanding of medical science and trusting our medical providers..

That said - like McBaker I chose a mastectomy - one and done, clean margins, totally clear - because it fit my age & quality of life requirements. Two years later "it" came back as Stage 3. So yes, at that point I threw the kitchen sink at it.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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May 28, 2021 08:23AM Aram wrote:

MochiPie, I believe in your case, early breast cancer with tumor less than 2 cm, Perjeta is not even approved to be used. This is from Genentech website:

PERJETA® (pertuzumab) is approved for use in combination with Herceptin® (trastuzumab) and chemotherapy for:

use prior to surgery (neoadjuvant treatment) in people with HER2-positive, locally advanced, inflammatory, or early stage breast cancer (tumor is greater than 2 cm in diameter or node-positive). PERJETA should be used as part of a complete treatment regimen for early breast cancer.


The main question is for node negative patients with tumors greater than 2 cm.

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/9/2021 AC + T (Taxol) Targeted Therapy 6/1/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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May 28, 2021 12:30PM Melbo wrote:

I was considered node negative with a 2.8cm tumor so they called me 2a and I did TCHP. (One node looked suspicious on scans, but biopsy didn’t catch any cancer.) It wasn’t even really a conversation about the TCHP though — the doctor said that’s what they recommended and when I talked to my nurse mom who runs the clinical trials program for her small hospital in Oregon, she said TCHP was standard - so I went with it.

I’ve tolerated the Perjeta fine. I have diarrhea more days than not, but most of the time it’s just “the runs” rather than being painful or super duper “oh no” urgent. Plus Imodium tends to keep it under control.

I had PCR with TCHP and my MO said that all but one of his patients has had PCR since he added the Perjeta to the standard mix. I’m also glad I did the Perjeta because when they did surgery it looks like my “negative” node may have actually been positive since it reacted to the chemo like there was cancer in there.

Diagnosed right before my 42nd birthday. One husband, two dogs, one cat and no kids. Dx 7/16/2020, IDC, Left, 2cm, Stage IIA, Grade 3, 1/7 nodes, ER-/PR-, HER2+ Chemotherapy 8/7/2020 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 8/7/2020 Herceptin (trastuzumab) Targeted Therapy 8/7/2020 Perjeta (pertuzumab) Surgery 12/20/2020 Lumpectomy: Left; Lymph node removal: Sentinel; Reconstruction (left); Reconstruction (right) Radiation Therapy 1/31/2021 Whole-breast: Breast, Lymph nodes
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May 30, 2021 11:47PM BSandra wrote:

Melbo, I second very much to what you say. Perjeta is added with minimal SE and more PCRs generally are observed. Anyways, my point for this discussion was that "LN negative" is a tricky thing, I know it from our own experience:/ Saulius

Since May'21:NED. Mar'21:axilla LN surgery. Sep'19-Mar'21:NED. Feb'19:recurrence, left breast,IBC. May'18-Feb'19:NED. Jun'18:DC/CIK. Aug'17:stage IV de novo at age 33. Dx 8/4/2017, IDC, Left, 6cm+, Stage IV, metastasized to liver, Grade 2, ER-/PR-, HER2+ (IHC) Chemotherapy 8/27/2017 Taxotere (docetaxel) Targeted Therapy 8/28/2017 Herceptin (trastuzumab) Targeted Therapy 8/28/2017 Perjeta (pertuzumab) Chemotherapy 3/12/2019 Taxotere (docetaxel) Surgery 7/22/2019 Mastectomy: Left Radiation Therapy 9/9/2019 Whole-breast: Lymph nodes, Chest wall Surgery 4/15/2021 Lymph node removal: Underarm/Axillary
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May 31, 2021 02:16AM Mausie wrote:

Hello everyone,

I was wondering if anyone originally had zero lymph nodes positive at surgery, but went on, years later, to have bone mets?


Thanks

Mausie

Mausie Dx 9/2006, IDC, 2cm, Stage IIA, Grade 3, 0/4 nodes, ER-/PR-, HER2+ Surgery 9/5/2006 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 9/9/2006 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Fluorouracil (5-fluorouracil, 5-FU, Adrucil) Radiation Therapy 2/7/2007 Breast Targeted Therapy 3/1/2007 Herceptin (trastuzumab) Dx 9/9/2013, IDC, 1cm, Stage I, Grade 3, 0/0 nodes, ER+/PR+, HER2- Surgery 9/11/2013 Lumpectomy: Right Hormonal Therapy 9/17/2013 Femara (letrozole)
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Jun 1, 2021 07:46AM Aram wrote:

I had my appointment today. I have been approved for Prejeta. I should do the one step at the time thing more often. I made it a hard week on everyone around me trying to figure out what to do if I am not approved and it didn't come to that at the end.

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/9/2021 AC + T (Taxol) Targeted Therapy 6/1/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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Jun 1, 2021 10:55PM BSandra wrote:

Dear Aram, congratulations - one more step to a cure! Saulius

Since May'21:NED. Mar'21:axilla LN surgery. Sep'19-Mar'21:NED. Feb'19:recurrence, left breast,IBC. May'18-Feb'19:NED. Jun'18:DC/CIK. Aug'17:stage IV de novo at age 33. Dx 8/4/2017, IDC, Left, 6cm+, Stage IV, metastasized to liver, Grade 2, ER-/PR-, HER2+ (IHC) Chemotherapy 8/27/2017 Taxotere (docetaxel) Targeted Therapy 8/28/2017 Herceptin (trastuzumab) Targeted Therapy 8/28/2017 Perjeta (pertuzumab) Chemotherapy 3/12/2019 Taxotere (docetaxel) Surgery 7/22/2019 Mastectomy: Left Radiation Therapy 9/9/2019 Whole-breast: Lymph nodes, Chest wall Surgery 4/15/2021 Lymph node removal: Underarm/Axillary
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Jun 3, 2021 05:00AM Aram wrote:

Thanks Saulius.

I had a very strange reaction to Kanjinti yesterday. About an hour into the infusion I got the worst chills of my life and I started shaking uncontrollably. They stopped the infusion and administered Benadryl and Pepcid. That calmed the shivering down a little bit and the nurse resumed the Kanjinti after checking with the doctor. The nurse told me I am not the only one with this reaction but I had never seen it on BCO. Any of you had a similar experience with Herceptin/Kanjinti and does it get better in future infusions?

Thanks.

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/9/2021 AC + T (Taxol) Targeted Therapy 6/1/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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Jun 3, 2021 05:53AM MochiPie wrote:

Aram - I received Kanjinti for 5 infusions before I was switched to Herceptin. I didn't have chills, but my first infusion was either 60 or 90 minutes and about 5 minutes before it ended, I had facial flushing and alerted the nurses. I had the same outcome - stopped infusion, more Benadryl (IV this time), restart infusion. I was fine for every other infusion without additional meds, though I had IV Benadryl for all subsequent infusions.

Dx 11/3/2020, IDC, Right, <1cm, Stage IA, Grade 3, 0/2 nodes, ER-/PR-, HER2+ (IHC) Surgery 11/10/2020 Lumpectomy: Right Chemotherapy 12/8/2020 Taxol (paclitaxel) Targeted Therapy 12/8/2020 Herceptin (trastuzumab) Radiation Therapy 3/21/2021 Whole-breast: Breast
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Jun 3, 2021 06:43AM Aram wrote:

Thanks MochiPie. I was very concerned yesterday that I might not be able to handle Kanjinti/Herceptin. I did a little bit of Googling and it seems 40 percent of people got the chills during trail. I am not sure why it was not mentioned to me as a common side effect.

Do you know why they switched you to Herceptin?

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/9/2021 AC + T (Taxol) Targeted Therapy 6/1/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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Jun 3, 2021 11:04AM - edited Jun 3, 2021 11:14AM by MochiPie

Aram -

Interesting question on the switch. I was told I was getting Herceptin, and my care plan mentioned Herceptin by name. Evidently the month I started treatment, the hospital switched to Kanjinti. I was never told I was getting Kanjinti and never gave informed consent for a biosimilar. In fact, I was told, here are your meds, please go online and research them and let us know if you have any questions about side effects, etc.

I hit the roof when I figured it out, and asked for a medical, not fiscal reason for the switch. Plain and simple, Kanjinti "works the same" but is cheaper. I have good insurance and I said I wanted Herceptin, the drug with a longer track record of successful patient outcomes and with a longer FDA approval. I think Kanjinti was approved in 2018 if I recall correctly. Some nurses were trying to say it was a generic version of Herceptin, which it is not. Ultimately I would probably have been fine with Kanjinti, but I really felt like some shady business was going on in order to save a buck. Not to scare you, as plenty of people on here are taking Kanjinti. I'm still pretty livid about the switch, to the degree of "now we're going to start your Herceptin" in the infusion center. I don't do well with feeling like I'm being deceived as I'm one of those skeptical/trust nobody people. However, I had no reason not to believe them. I've checked every single infusion bag since I found this out, and you should check yours too just as a failsafe.

Credit to my oncologist, who met with me after I noticed the switch, and said it was a recent decision to switch that was not made at her level, but higher up and hospital-wide. She said that clearly there needed to be some staff education/training happening as nobody should be referring to Kanjinti as Herceptin. She was also going to escalate the issue to be sure that other patients were not also told they were getting Herceptin, because it's given to people with other cancers than just breast cancer. I think I sort of forced the Herceptin issue anyway since what they did to me was unethical and illegal, but in the end I got it and I'm still getting it. Also, pretty sure the manufacturers of Herceptin would not appreciate patients being told they were getting their med and then getting a competitor's med instead.

Dx 11/3/2020, IDC, Right, <1cm, Stage IA, Grade 3, 0/2 nodes, ER-/PR-, HER2+ (IHC) Surgery 11/10/2020 Lumpectomy: Right Chemotherapy 12/8/2020 Taxol (paclitaxel) Targeted Therapy 12/8/2020 Herceptin (trastuzumab) Radiation Therapy 3/21/2021 Whole-breast: Breast
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Jun 3, 2021 11:19AM Aram wrote:

MochiPie, that is very wrong of them not to inform you. My doctor mentioned from the beginning it is Kanjinti. At the infusion site, nurses and pharmacists call them by their chemical names: trastuzumab and pertuzumab. Also before getting each drug, the nurse shows me the bag to validate my name, date of birth and the medication name. I was under assumption that is the standard everywhere.

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/9/2021 AC + T (Taxol) Targeted Therapy 6/1/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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Jun 3, 2021 12:17PM MCBaker wrote:

Yes, little need to drop names in a situation like this, but I will. I doctor with Mayo. and anything other than "the nurse shows me the bag to validate my name, date of birth and the medication name. I was under assumption that is the standard everywhere." would be an egregious violation of procedures.

Mary Dx 10/3/2018, DCIS, Right, 6cm+, Stage 0, Grade 3, ER-/PR- Surgery 11/15/2018 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement Dx 11/16/2018, IDC, Right, <1cm, Stage IA, Grade 1, 0/5 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 12/18/2018 Herceptin (trastuzumab) Chemotherapy 12/19/2018 Taxol (paclitaxel) Surgery 6/27/2019 Reconstruction (right): Fat grafting, Saline implant
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Jun 3, 2021 01:49PM MochiPie wrote:

Sorry, all re: Kanjinti substitute and ethics. To clarify, the nurses did verify my name and DOB and said the mg of trastuzumab I was getting. And then they would say to me, "ok so this is your Herceptin," only it was Kanjinti (trastuzumab-anns) at the time and not actually Herceptin. But my written plan of care says I'm to get Herceptin, and you can be sure I have saved screen shots of that!

Dx 11/3/2020, IDC, Right, <1cm, Stage IA, Grade 3, 0/2 nodes, ER-/PR-, HER2+ (IHC) Surgery 11/10/2020 Lumpectomy: Right Chemotherapy 12/8/2020 Taxol (paclitaxel) Targeted Therapy 12/8/2020 Herceptin (trastuzumab) Radiation Therapy 3/21/2021 Whole-breast: Breast
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Jun 3, 2021 11:21PM BSandra wrote:

Dear Aram... seems like some allergic reaction? Could it also be the infusion solution was too cold? My wife gets Herzuma - our NCI does not buy Herceptin anymore:/ Anyway, I never understood Roche (okay, I understand they wanna profit as much as they can but they had Herceptin patent for 20 years and it was a total best-seller) why make Herceptin so expensive - even biosimilars, although cheaper, are aligning to that price. Roche could drop the price for competition reasons but they are not doing it. Means probably trastuzumab's days are over - other novel, improved trastuzumab, antibodies are coming... Saulius

Since May'21:NED. Mar'21:axilla LN surgery. Sep'19-Mar'21:NED. Feb'19:recurrence, left breast,IBC. May'18-Feb'19:NED. Jun'18:DC/CIK. Aug'17:stage IV de novo at age 33. Dx 8/4/2017, IDC, Left, 6cm+, Stage IV, metastasized to liver, Grade 2, ER-/PR-, HER2+ (IHC) Chemotherapy 8/27/2017 Taxotere (docetaxel) Targeted Therapy 8/28/2017 Herceptin (trastuzumab) Targeted Therapy 8/28/2017 Perjeta (pertuzumab) Chemotherapy 3/12/2019 Taxotere (docetaxel) Surgery 7/22/2019 Mastectomy: Left Radiation Therapy 9/9/2019 Whole-breast: Lymph nodes, Chest wall Surgery 4/15/2021 Lymph node removal: Underarm/Axillary
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Jun 4, 2021 06:49AM Aram wrote:

Hi Saulius, yes apparently an allergic reaction. I looked it up and apparently in trials about 40% of participants had the chills. I was surprised because I didn't know but the nurse told me it is very common. I wish I knew before starting though, I was so concerned that we might need to stop Kanjinti and that is an awful news for Her2+.

I don't understand pricing of Herceptin either. It is just so expensive that for years, many couldn't afford it around the world. I am very happy there are biosimilars now and more accessible to everyone but I still would have liked to have Herceptin itself just because of the longer time it has been used. My MO mentioned Kanjinti has shown slightly better performance in trials. Hopefully that is the case.

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/9/2021 AC + T (Taxol) Targeted Therapy 6/1/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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Jun 6, 2021 11:19PM BSandra wrote:

Dear Aram, I think Kanjinti showed better results because it has another chemical formulaiton and maybe is more deliverable to tumors (do not know the details but trial clearly states it is more effective) - that is good news. I also think your next infusion will be different from the last one - body adjusts itself with time. Saulius

Since May'21:NED. Mar'21:axilla LN surgery. Sep'19-Mar'21:NED. Feb'19:recurrence, left breast,IBC. May'18-Feb'19:NED. Jun'18:DC/CIK. Aug'17:stage IV de novo at age 33. Dx 8/4/2017, IDC, Left, 6cm+, Stage IV, metastasized to liver, Grade 2, ER-/PR-, HER2+ (IHC) Chemotherapy 8/27/2017 Taxotere (docetaxel) Targeted Therapy 8/28/2017 Herceptin (trastuzumab) Targeted Therapy 8/28/2017 Perjeta (pertuzumab) Chemotherapy 3/12/2019 Taxotere (docetaxel) Surgery 7/22/2019 Mastectomy: Left Radiation Therapy 9/9/2019 Whole-breast: Lymph nodes, Chest wall Surgery 4/15/2021 Lymph node removal: Underarm/Axillary
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Jul 6, 2021 02:45PM Docy wrote:

does any one know if Kadcyla can be given with out steroids.

I May have atypical stress fracture of my both femurs from steroids. I’m also taking Boniva for for osteopenia

and according to insert Boniva can cause this atypical stress fractures and is aggravated with Steroids.

Thanks

Docy Dx 12/2/2020, IDC, Left, 1cm, Stage IIB, Grade 2, ER-/PR-, HER2+ (FISH) Chemotherapy 12/20/2020 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 5/13/2021 Lumpectomy: Left Targeted Therapy 6/16/2021 Kadcyla (T-DM1, ado-trastuzumab) Radiation Therapy 6/21/2021 Whole-breast: Breast, Lymph nodes
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Jul 6, 2021 03:57PM leftfootforward wrote:

I have never taken steroids while on Kadcyla. Been 2 years.

Dx 12/13/2010, IDC, 3cm, Stage IIIA, Grade 2, 1/16 nodes, ER-/PR-, HER2+ Dx 12/4/2012, IDC, Stage IV, 0/0 nodes, ER-/PR-, HER2+

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