What next after kadcyla?

[Nikita1806]

Hi All,

My mother is stage 4 patient and right now we are very confused on what should be her next line of treatment.

History -

March 2018 - Lump in breast, found it was already metasized to lungs liver.

March 2018 - started with chemo along with herceptin (TCPH)

June 2018 - Everything clear, started with herceptin maintenance dose and altraz.

Feb 2019 - During her 18th herceptin, found the lump again in the same spot.

March 2019 - Single mastectomy to remove the breat with the lump.

April 2019 - started with Lepatinib and letrozole.

August 2021 - Found some lymph nodes light up in lungs during annual petscan. Doctor asked for observation.

Dec 2021 - Did petscan again, found lesion in lungs. Performed SRS surgery in brain. Started with kadycla for lungs.

March 2022 - pet scan - lymph nodes stable.

June 2022 - pet scan - lymph nodes stable.

Sept 2022 - pet scan - new lesion in lungs.

Now all the doctors we are consulting are giving different opinions -

As she is low er and pr positive , we can start with ibrance.

As she is in good healthwise , we can give again chemo with perjata. (last time perjata was not given, i am not sure if that will be helpful this time? )

Start with Neratinib tablets.

Radiation and biopsy is out of picture.

Tucatinib and en hertu are not available in india.

If someone had similar experience, please let us know so that we can make an informed decision based on all the information we have.