Today’s question involves Herceptin vs Kadcyla

[Jpl5036608]

My daughter has stage 4 Her2 positive with tiny liver mets. She finished tchp in march 18 and is on herceptin and perjeta every three weeks since then. One liver lesion went from 1.3 cm to 1.5 cm and the other from 6.4 to 6.7 mm. Remaining 4-5 lesions are too tiny to even note. When would the onc switch to Kadcyla instead of herceptin if there is even minute growth?

[Bubbles001]

My understanding is a 20 percent progression is the criteria used in clinical trials for progression. It’s called RECIST criteria and you can google it to see the calculation. Your daughters tumors are so small, the Onc may wait longer to switch because the measurements are not always exact.

[Amf1983]

hi Jpl5036608

I have have stage IV Her2 + with mets to lungs and spine and brain . I have been on herceptin since march of 2019. I started with herceptin , perjeta and taxotera and xgeva. Only the brain grew so I continued on herceptin xgeva and added kadcyla to help brain mets . I didn’t have any results with kadycla , more grew in brain . I had whole brain radiation about 9 months ago. At that time I switched to neratinib , xgeva capacedebein and herceptin . My lung and spine mets are almost gone as well as brain mets. Sorry for the long story but main point is I’m still on herceptin every 3 weeks . Not sure why they can’t add kadcyla to herceptin ? Best of luck to your daughter ,

[Jpl5036608 in reply to Amf1983]

Thank you!! Good luck to you!