No option!?

[Goga156]

I am writing for my mother who has mbc. So far she has received anastozole, nolvadex for the early stage, and for mbc fulvestrant +ibrance, paclitaxel, capecitabine, she is currently on vinorelbine iv. He has metastases on the liver and bones, so far he is stable. liver biopsy: er 70%, pr 0%, her2 1+, ki67 18%; pik3ca negative, brca negative. eribulin, halaven, orserdu, enhertu are not available here. So we need a suggestion of what other therapies (perhaps older chemo) would come into consideration? The oncologist says he has nothing another to give her. Help, suggest what to do next...

[Kerryd22]

Where is here?

The taxane based chemotherapy should be readily available as it’s an old drug but it’s effective. You do lose your hair though. And it’s an IV chemotherapy so it’s not as convenient as a daily pill.

[Goga156 in reply to Kerryd22]

do you mean doxil? that is the only option, but they say only 6 therapies and nothing more. now he is on iv chemotherapy, so it is not a problem. we are in Croatia.

[Kerryd22 in reply to Goga156]

I’m not sure what it’s called elsewhere but taxane based chemotherapy is Paclitaxel and Nab-Paclitaxel, Taxol etc. I had 9 rounds of Nab-Paclitaxel (Abraxane) 2 weeks on one week off but I know others have been on it for twelve months and more. I don’t really understand why you would be limited to six infusions because that’s potentially two rounds based on three weeks on one week off which is done in some countries or three rounds based on two weeks on one week off. That’s a very small dosage and I’ve never heard of so few rounds.

Can you cross the border to get more treatment options? I know someone in Romania who goes to Israel because her options are so limited in Romania.

I really hope you do get some useful info although I’m in Australia so I’m not really the person to give it.

All the best to your mother.

Kerry

[Goga156 in reply to Kerryd22]

My mother had 22 round paklitaxel weekly, to progression. Doxorubicin (red chemoterapy) seems to be the only one, 6 rounds max..

[Bettybuckets in reply to Goga156]

hi Ladies- the 6 rounds for Doxil is because it is cardiotoxic but they did studies with people who had no other options and they did fine on a lot more rounds… I am on Doxil now and have very little side effects… it could be they are only giving me a small amount though. But I like it becuse it is only once monthly and then I can just get in with my life after a day or so around treatment . It is doxirubicin- an old drug in a new phospholipid layer that makes it more tolerable than the old red devil we all had in early breast cancer!

[13plus]

I can’t name them but I’m pretty sure there are more older chemo options. I had a doc prattle them off to me recently . Can your mum see another doctor at another hospital?

I wish the best for her

[Goga156 in reply to 13plus]

This is another opinion (state hospital too), maybe third opinion would be beter..

[caw517]

It sounds like my experience is similar to your mom. I have had breast cancer for 28 years but 8 years ago it became metastatic and since then I have been on a long list of drugs--Anastrozole, Ibrance with exemestane, then letrozol , then Faslodex,. When that didn't work everolimus then Xeloda and finally Cytoxan. I also was on verzenio for a short time.

My cancer became more aggressive and I had a small liver spot as well as small lung spot and continued bones metastases. I also developed many skin metastases.

My main point here is that my oncologist said we needed to come more aggressive. He put me on Doxil, which is also know as ribosomal doxorubicin. This is a form of adriamycin or doxorubicin but has fewer side effects and minimal hair loss. I am on treatment 3 of 6. The chemo treatments are every 4 weeks. I have had fatigue which remains from treatment through the second week as the main side effect. Then I pretty much feel normal. Nausea is managed easily with Zofran for 3 days after treatment.

I have not had a scan since starting treament but due to the many many skin lesions, which are shrinking, I can tell that Doxil is working. After the 6 treatments, I will go off all drugs as long as there is no progression. My oncologist feels that should be at least 6 months. If it does progress again, I will have 4 more treatments.

I hope this helps you. This was the best option that my oncologist could give me. I have had him my whole time and truly trust him

[Goga156]

unfortunately, doxil (liposomal) is unavailable in our country and we only have the old doxorubicin which is more difficult to tolerate. the mother has now less aggressive tumor according to the liver biopsy. I don't know why they don't want to give some hormonal therapy, she only received letrozole in the early stages, 2 and a half years after stopping taking it, she had relapse. what is your cancer hormone status, her2.. which country are you?

[caw517]

That's too bad that doxil(liposomal) is not available in your country. I am in the U.S.

My cancer is ER pos and Her2 neg. I mentioned xeloda on my list of drugs. I was on that one for 14 months and it was an easy drug. I only wish it could have worked longer. It is an oral chemo pill. Has this one ever been mentioned for your mother?

Hoping the dr can figure out a good plan. Please let me know. I understand how tough this is!!

[Goga156 in reply to caw517]

I forgot to write, mom was previously on Xeloda for 8 cycles. it was the hardest therapy for her due to fatigue..how is ki67? do you have any mutation?l

[caw517]

I was just recently tested and had the ESR1 mutation, but I am not eligible for the drug approved for that as I have used Faslodex too long already. I am not familiar with ki67. I wish I had more options to suggest. Verzenio did work for me for a while but I had to get off as I couldn't manage the diarrhea which was the worst side effect. Hope you can get plan.