Anthrocycline Chemo

[Jenjill47]

Hi Ladies,

following a fairly serious kidney infection, I had to stop chemo for 2 months. CA125 levels are high still. I see on the requisition that the oncologist is planning on treating me monthly with Anthrocycline. I am alarmed because on doing some research, I see it can cause serious cardiac damage. I had an echocardiogram weeks ago and she obviously has the results. (I don't yet). The treatment is to start next Wednesday and I have booked in to see her before that to discuss my concerns. Have any of you ladies had this treatment and do you have advice?

Thank you in advance,

Jill

[Lyndy]

Is this similar/ the same as Doxycycline? I don’t recognise the name... but you might get more responses if you edit to include other names it goes by in case people recognise them xx

[Jenjill47 in reply to Lyndy]

Thanks Lyndy.This is a copy and paste of what I found.

Epirubicin is an epimer of doxorubicin with important role in the chemotherapy treatment of both early and metastatic breast cancer. The efficacy of epirubicin is similar to doxorubicin while epirubicin has a different toxicity profile particularly in regard to cardiotoxicity.

No urgency as I will be seeing Oncologist tomorrow! I'll let you know the outcome.

xx

[fair-rosamund in reply to Jenjill47]

It's not the same as doxycycline but you will need monitored closely on an anthracycline, particularly for total cumulative dose as it seems to be that which causes cardiac problems Do discuss with your oncologist.

[Jenjill47 in reply to fair-rosamund]

Thank you fair-rosamond. I'm already wondering if it is worth taking a chance of heart damage. I'm a retired RN and while I'm fairly cluey about what is going on, I have to trust what Dr Kerry (ONC) has to say. But there needs to be clear and honest answers.

[soyoon]

It is very similar to Doxorubicin, I believe. If you take Doxorubicin as it is, you can get cardiac defect. So, they modified it by adding PEG an encapsulating peggylated Doxorubicin in liposome. It is called Doxil in the US and Caelyx in UK. With modification, the cardiac toxicity is not observed.

[Jenjill47 in reply to soyoon]

Thank You Soyon. I saw my oncologist today and she explained that there will be another drug given. Also that my cardiac situation will be monitored closely. Unfortunately the CT scan that I had yesterday shows further growth of the tumours. No invasion of the kidneys, liver etc, but what I thought was scarring following surgery are palpable tumours. We will go ahead with the chemo --- following that she mentioned an immunotherapy trial. We also discussed how far I want to go with ongoing treatment. Realistically, I want to be practical and but not live a life in and out of treatments. I'm 73, have great family support and reckon that is pretty good innings.Thank you again.

[soyoon in reply to Jenjill47]

Whatever you decide, I thought I would share with what I wrote a few days ago on this forum in response to a question on immune therapy for OC . It is a brief summary of what I have learned about immunotherapy. I hope you find it helpful.

1) antibody conjugated to chemotherapy drug--the targeted proteins with antibodies are mesothelin (CA125 receptor), MUC16 (CA125), folate receptor. The chemo part is typically taxol. You need to have your tumor tested for its expression, like mesothelin and folate R.

2) CAR-T cell therapies. There are many different varieties in trials. The basic concept is to obtain T cells from your blood or tumor (in this case, tumor infiltrating T cells), and modify it by introducing a new segment in T cell proteins so that it can recognize unique or highly expressed proteins on the tumor (mesothelin, MUC16, and folate R). Sometimes, this approach alone doesn't work well, so it is combined with PD-1/PD-L1 antibody.

PD-L1 is typically expressed in tumors (mine has it as well), and PD-1 in tumor combatting T cells. When T cells reach tumors, it is being inactivated by the PD-L1 in your tumor. So, the antibody is designed to bind to PD-L1 on your tumor, so that your T cells can do the tumor killing job.

There are many efforts trying to make T cells more combative, so the field is continuing to modify T cells by various means. Also, researchers are continuing to look for markers that are expressed only in specific tumors, and its number are growing.

You can get a lot of information in NIH or NCI clinical trial website. Or, you can visit hospitals that are doing a lot of immuno therapy trials. In the US, they are Sloan Kettering, MD Anderson, University of Pennsylvania, Roswell Park Hospital, and Dana Farber.

Once you are interested in one, you contact the person in charge, and they will send you a questionnaires which would help them decide your eligibility.