I was diagnosed about 3 months ago with bone Mets after 22 years from my initial diagnosis I am taking anastrozole and Ibrance. After two months on I brance the dose was lowered as my ANC was .9. I wonder if I should have stayed on the higher dose a little longer. It was mentioned earlier I might have to lower it if it keeps declining At a visit I asked about it and my Dr lowered it. Want to fight it with everything I can like I did 22 years ago. I understand a lot of people go on lower doses. My question is at what level of anc is it typical. What is the target ANC is a better question. Thanks so much. I am enjoying reading the posts.
Ibrance: I was diagnosed about 3 months... - SHARE Metastatic ...
Ibrance
![mkrienke55 profile image](https://images.hu-production.be/avatars/2f73bcb063c54613bc7d36e345b2a0e4_small@2x_100x100.jpg)
![mkrienke55 profile image](https://images.hu-production.be/avatars/2f73bcb063c54613bc7d36e345b2a0e4_small@2x_100x100.jpg)
Mkrienke55, sorry you have joined us - 22 years after your original diagnosis , must have been a surprise !
My stage IV dx came 11 years after my stage 1 dx. I am on Ibrance and fulvestrant (had been on letrozole for about 7 years after my stage 1 dx).
I also had low wbc on 150 mg of Ibrance so after a few cycles where my oncologist had me wait an addl week off to let my anc recover , my dose was lowered to 100. Even at 100 my anc / wbc would fall , sometimes below .75. After 1 year on Ibrance my dose was lowered to 75 mg. On this dose my anc / wbc was better and rarely falls below .90.
I started 11/ 2019 so have been on Ibrance / fulvestrant for almost 4 years . My oncologist is ok with me starting Ibrance if my anc is over .80 after the week off (3 weeks of Ibrance and one week off). She prefers me on 75 mg with the 3 week on / 1 week off cycle vs needing to take addl weeks off to allow my ANC's to recover . I have never had any fevers or issues when my anc has dropped to a low level. This past week on day 28 my anc was 1.2!
I have had clear or no evidence of active disease on scans for 3 years now , which is a relief . I hope this info helps - I have found Ibrance easy to tolerate and hope it is for you as well !
The target seems to be 1 but .9 is common. Cancer treatments are designed around the highest tolerable dose not the lowest effective dose so lowering the dosage doesn’t mean the drug won’t work. There’s been a lot of work done in this field on our behalf by people like Bestbird (Anne Loesser). She’s literally written the book about metastatic breast cancer.
I Started on 100 as recommended. We tried for a few cycles, but I had to have too many weeks off in between to recover. They then lowered me to 75, but even then I could not do the 3 weeks. I continued on 75 for 2 weeks on 1 week off and felt really good. Passed all my tests and had a great 4-5 months. But my 15-3 marker was going back up, so I asked if it was a possibility of doing a combo of 100/75, still just 2 weeks on. We tried, but I have felt very bad and blood tests kept failing. My philosophy has been quality over quantity, so I am back on just 75 and already feel so much better.
Wow - 22 years is a long time for your cancer to sleep! What a shock to hear it came back. I had eight years cancer-free and I thought I was through with all that but...no. I'm 6 1/2 years out from my MBC diagnosis and have been on Ibrance/letrozole the entire time. Was only on 125mg of Ibrance for a few months, then on 100mg for 5 1/2 years now I'm at 75mg. All of these changes came from my ANC being low. It's still low - I often have to wait a week to start again - this last month my number was .7 so I had to wait a week until it was .9. My oncologist is very casual about this - he will approve restarting at .8. I haven't had any infections or illnesses.
Sending hugs
Susan
Hello and welcome.
I was diagnosed 5 and a bit years go. Bone mets only. But everywhere. And I've been on Ibrance and Anastrozole for 4 of them. Prior to that I was on Letrazole and Ibrance. But my dose was lowered after only a few months of taking Ibrance, and by all accounts, from others here too, I have heard that it doesn't make that much difference.
It's what you can cope with. And far better to do what your onc suggests, I think. I have been told that my Oncologist is one of the leading researchers in the world. And I'm lucky enough to have her here in Melbourne. She's ver humble and really thoughtful. I would say if she has lowered mine because o f high WBC, then your doc is also doing the correct thing.
Fight from the inside. Fight in your heart. Do all the things you want and don't do things you don't want. Have fun while you can and keep positive to a point. Also grieve when you need to. these aare my Mottos. X
Chris
Hi Chris, I love your Mottos ☮️🌺
I'm in the UK and was told ANC needs to be 1 or above to receive treatment. My bloods are tested the day before new pills issued. I started on 125mg but couldn't achieve the target with 7 day break so reduced to 100mg and now maintain 21/7 routine.
If you search on here there was a post which said that lower dose doesn't reduce performance as the ideal dose is what your body tolerates.