I recently visited my doctor at MD Anderson the Woodlands. I see him as a back up to hold my oncologist accountable. He told me that my treating Oncologist should be giving me Neulasta because my neutrophils do not go back into range for three weeks after my last Ibrance. So I’m basically three weeks on then three weeks off. Does anyone else get a Neulasta injection during their off week?
Thanks for the input
Christina
Christina,
I am on Ibrance and mine get low. I was told that the things for low counts work with IV chemo's but not Ibrance. Mine usually go around 1.0 but I was told that I could go as low as .75. My last one was .62. I was just there for a blood draw and port flush. The nurse didn't alert the doctor and gave me a copy. It still doesn't feel like it is up to normal. Let me know if you find out because I sure would like to have something to bring it up. Blessings Hannah
I will update. My neutrophils get as low as .500 and that is on 100mg. The doctor in Texas MD Anderson says it’s not good to be on 75mg. If his patients can’t handle Ibrance he doesn’t go that low, he switches them Verzenio. If his patients go under .100 for more than 10 days he gives them Neulasta. I’m not sure what the standard is, I’ve been told that this hospital is the leader in breast cancer treatment.
Thanks for everyone’s input!!
Christina
Did he indicate to you why 75 mg is not good? I am starting Ibrance with 75mg because I had surgery for a broken femur due to bone mets recently and another surgery on my tibia a month later. I am still healing and will be for awhile. I have read that 75mg can be effective. Have I been misinformed?
I was always off three weeks too. My oncologist said the shots wouldn’t work as you would only have a couple days the neutrophils would be high before they drop. Plus the fact it is really expensive.
im going to give it a try. There’s a reason for us to be off for only a week. The trials were conducted using 125 mg also. It’s important to stay as close to the recommendations by the trails. I will update.
Good to hear someone is at least trying....😀
was told it doesn't work with CDK inhibitors like it did with chemo . It is not a standard of care
I can add that I received Neulasta on chemo and then was on Ibrance and to follow with Verzenio same onc neutrophils were always at 1.0 range Neulasta was not ordered and believe me if it was needed or worked they would have given It. This institution believes in more drugs not less!
When it got too low they just stopped Ibrance for a few days.
I've had a couple of Neuprogen shots and it does boost your neutrophils but it is pretty short lived. We had a trip planned and would be out of the country so dr felt the boost would be helpful. I also took an extra week off Ibrance. It is very expensive! Ins covered it but required a pre authorization.
Hello Christina ! I haven’t heard of Neupogen /Neulasta shots generally being given between Ibrance cycles to boost wbc , but I was given a few shots to do at home after an operation (breast reduction) whilst on the Ibrance /Letrozole protocol . The aim was to reduce the risk of infection , (alongside antibiotics) , by boosting my wbc , whilst off Ibrance for a week or two. It did work for me (my wbc went up ten-fold in the 4 days of taking 4 daily shots ). Luckily I didn’t have to pay for it , being on the N.H.S. (which for Neupogen is around £250 for a pack of 5 shots here in the U.K.)
Wouldn’t it be great if there was something available to help all the ladies with neutropenia ! Good luck ! x
I never had neulasta administered on my off week. My WBC never go upwards beyond 2.0 and the last ones were 2.0, 1.8, 1.6. I'm happy to learn this & will ask Onc on next visit. Thanks.
disregard my response. you mentioned neutrophils, I mistaken for WBC
Curious. If you feel you need a 2nd onco to keep your primary onco accountable, why would you continue to go see your primary onco. Do you then tell the primary one that your second onco suggests another addition?
I was started on Ibrance right after I was diagnosed and understood nothing. I was on for three weeks, then one week off. My week off was a horror. I would lay in bed in August with the air conditioner off and literally be freezing and shivering. I then had a minor infection that used to be able to be handled easily with antibiotics but the Ibrance had killed my immune system. Had to have surgery and a one month recovery turned into four months.
The only thing I learned is that you cannot go by anyone else's experience. We are all on different other meds, different health situations, etc. I found there were ladies that felt great on their week off and others felt the same on and off Ibrance.
I hated it bc the week off was scary for me. I could not even get out of bed. So I learned we all have different experiences. If I read that someone has a side effect very similar to one I have, I may question how they deal with it, but other than that I leave that to the doctors.
I did not even know I could have asked for a lower dosage. Good luck.
You’ll find in many of these large hospitals that even though you only see one Oncologist there is a team behind him or her. In my case the hospital is small and my oncologist has no back up. Therefore, I took it upon myself to go seek another oncologist to help my primary make better decisions. I’m sorry about your situation. All of us have different stories and different journeys. The one thing that we all have that is the same, is wonders and concerns. There are many other medicines like Verzenio that might work better for you because the neutrophils will stay a little higher. I feel, that you can’t go with one opinion because there is 1 million more out there.
Based on what you are saying I would find a different Oncologist that has a team behind them.
Good luck
Christina
Additional treatment.
Two pet scans cancer free 
Platelets and raised markers
Neutrophils dropping 
Weekly schedule of 5 days on, and two days off CDK4/6 inhibitors
