People on here have been saying they are given 7 pills with their Enhertu.

[Figletf]

What are these 7 pills and what is their purpose?

[Iwasborntodothis]

I didn't have pills - I had pre-meds in my infusion. Zofran, Steroids, and Aloxi (?) - there was a lot more with Trodelvy - so much that my husband had a checklist and annoyed the staff but it made sense with all of those meds. He wishes I was still getting Benedryl so I won't talk his ear off on the way home. Also, it was interesting to me that Standard sodium chloride hydration is not compatible with Enhertu and a different type is used. I'm sorry I don't remember what it was but the pharmacist knew this and sent the proper hydration with the meds. (I cringe writing this because I don't want to freak anyone out or mis-speak but I did just look it up)

[awesome4ever in reply to Iwasborntodothis]

Alison I'm glad that you have started Enhertu with minimal issues. I hope it continues to be the same and is effective for as long as possible. Many chemotherapy drugs(old and new) are not compatible with normal saline and have to be mixed with D5W. No one needs to be concerned as compatibility is clearly marked and flagged by the manufacturer so the pharmacy team know what to mix it in. LOL on your comment about no Benadryl and your hubby. You continue to be an inspiration to us all. Take care.

[Iwasborntodothis in reply to awesome4ever]

So here's a technical question - if you need to have this for infusion, do you have to request it during treatment if you were hospitalized (God forbid) for something else? In other words, would a saline infusion for other reasons be bad? Not something to fret about just curious. I'm going to ask my NP tomorrow when I go in for my "toxicity check".

[awesome4ever in reply to Iwasborntodothis]

Hi Allison. All drugs that require reconstitution for administration are required by the pharmaceutical company to supply a reconstitution guide which tells the pharmacist, nurse etc what is to be used. I'll include 2 examples of recent drugs Enhertu ( requires D5W) and Trodelvy(N/S) for examples. It doesn't matter where the drug is being infused they all have to use these guidelines. If a company specifies a solution it is usually because during testing one of the solutions did not allow the drug to meet their bioavailability criteria to reach the cell for it's use.

enhertuhcp.com/-/media/enhe....

trodelvyhcp.com/-/media/pro...

Not to get too technical but all IV solutions are broken down into being either isotonic, hypotonic or hypertonic based on the osmosis process in the cells.

Normal saline is isotonic and generally is safe to use for most hydration needs with the exception of patients with heart disease, kidney disease or those prone to fluid volume overload. However in all patients they need to be monitored for hyperchloremia and hypernatremia which can be life threatening if not treated promptly. This isn't a concern when D5W is used.

So in general unless you are critically ill or have one of the conditions I mentioned above saline is safe. Your physician team can determine and specify when they order the drug...if they want something out of the norm. However if they order a solution that is contraindicated by the drug manufacturer they will be questioned and would likely be told to contact the company themselves for clarification.

Hope I answered your question somewhat. Take care.

[Iwasborntodothis in reply to awesome4ever]

You are the best thank you so much for this detailed reply and for not making me feel silly for asking. You are a true blessing for all of us.

[Figletf in reply to Iwasborntodothis]

This was a new clinical trial where the first in human PARP inhibitor was added to Enhertu to be taken in pill form for seven days. The patient was in the Boston area

[Figletf in reply to Iwasborntodothis]

A PARP inhibitor is a targeted cancer drug that prevents cells from repairing damaged DNA. PARP stands for poly (ADP-ribose) polymerase, an enzyme that helps repair DNA breaks.

PARP inhibitors work by trapping PARP at DNA damage sites, which causes a buildup of unrepaired single-strand breaks. This leads to double-strand breaks, which can't be repaired in cancer cells that are deficient in homologous recombination (HR). This results in genomic instability and cell death.

PARP inhibitors are especially effective against cancers with gene mutations that affect DNA repair, such as BRCA gene mutations. They can be used to treat breast, ovarian, and prostate cancer.

Examples of PARP inhibitors include: Olaparib, Talazoparib, Rucaparib, and Niraparib.

PARP inhibitors can significantly improve the long-term survival rate of tumor patients. However, they may increase the risk of adverse reactions, but are generally safe and controllable.

[Iwasborntodothis in reply to Figletf]

Got it. My last treatment was Lymparza - a parp inhibiter and we fought the insurance to get it because I wasn't BRCA. I think it worked, in that, I didn't have any significant spread - just rising CA15 - and it gave me a break from IV. I think it is part of the future and as I said somewhere else, we need to ask about these options for sure.

[Figletf in reply to Iwasborntodothis]

Yes,I am going to ask my team at Moffitt

[13plus in reply to Figletf]

Do you know if the trial you're refering to here was called Combomatch?

[Figletf in reply to 13plus]

Starting a new trial - Petra"healthunlocked.com/share-me...