First scan after Enhertu

[Flower1513]

Update!!!!!!!! Mom is continuing her Enhertu and they feel it’s working her tumor markers dropped again. Anything with bone they feel is treatment flair, they will closely monitor lungs. Thanks so much ladies!!!!! My mom had her first scan after 4 enhertu treatments. Her tumor markers have dropped over 200 pts. She was stable and slight improvement in some areas. But also some new lesions on bones . So confusing !! It had been 4 months since last scans. And she was off any meds for 5 weeks before starting in Enhertu. Her lungs also showed some ground glass opacity . Her doc said it was very subtle. But now have to figure out if it’s from meds or sickness . I know her oncologist will direct us. But any input ? This is her 4th treatment . I guess I’m wondering if this is going to be another change in meds. With her tm dropping so much. I was a little in shock over any progression ! Thanks ❤️

[HelenWi]

Gosh, that is definitely confusing with the markers dropping but new lesions found. What did the markers drop from? Maybe you can zap the new lesions and keep using Enhertu till the next scan?

Enhertu does cause pneumonitis which is treated with steroids. (I got pneumonitis from Ibrance and took prednisone for a few weeks but I actually had a cough. I think there are guidelines depending on how severe the inflammation)

Here’s a bit of info I found:

According to current guidelines, patients receiving Enhertu (trastuzumab deruxtecan) should be monitored for pneumonitis with a chest CT scan every 6-12 weeks, with more frequent scans considered if symptoms of lung issues like cough or shortness of breath arise; this monitoring should include both clinical assessment of symptoms and regular imaging studies like high-resolution CT scans

I hope your onco helps with a good solution. Take care and blessings to both of you.

[Goga156 in reply to HelenWi]

it is possible that the visible metastases on the bones are only the result of the treatment, it is possible that they were there before enhert but still unnoticeable on CT. are they sclerotic? in our case, they would continue with the same therapy with radiation of metastases. where do you have metastases?

[Flower1513 in reply to Goga156]

Yes it mention sclerotic in the report . She has bone liver and lungs . But everything is stable except for bones. Yes, I was wondering if this was there before enhertu. Also her last scan was July 18th was on no meds at all for 5 weeks. Untill starting Enhertu and scans yesterday after 4 treatments . Thanks so much for replying

[Flower1513 in reply to HelenWi]

Her was markers were 558 start of treatment down to 330 last checked . I’m really praying this didn’t affect her lungs and she can stay on treatment . Thanks so much for including the info on the guide lines. Her doc did say whatever was going on was very subtle . She really hasn’t had any symptoms . I know we will find out more on Thursday . My mom is very strong in her faith and trusting God to continue guiding us every step. Thanks you so much!

[Praising in reply to Flower1513]

So glad we have God to guide us. Our good shepherd knows how hard this is….and my faith is in Him. Prayers.

[Praising in reply to HelenWi]

Is it best to have new lesions radiated ? Have you done this?

[HelenWi]

I mentioned because I had that done once. I was on Piqray and a scan showed a couple new lesions while others were stable.. my onco wanted to try and stay on Piqray as long as possible. So he suggested we just radiate the new ones rather than change drugs. After that, I got no more new ones and stayed on Piqray for maybe six months more.. so I guess it was a gamble, not a huge one, and it paid off.

[Flower1513 in reply to HelenWi]

Thank you! That would be great if they let her do that.