New Treatments For Breast Cancer Pertuzumab and Ado-Trastuzumab Emtansine
Fear of the unknown sometimes paralyzes us. Knowledge doesn't always help. The knowledge of these two drugs might help with the fear.
Are these wonder drugs? Do they really extend life? I am four years into my third bout of cancer. One was a tumor on my optic nerve when I was five. The next was breast cancer just after my fortieth birthday,the most recent was four years ago and has been ongoing.
As recently as five years ago a woman with metastatic (in the bone) breast cancer had a five year life expectancy. The treatments were harsh and sometimes debilitating. Well here I am four years down the road, While I have curtailed running I am still swimming and cycling and walking/hiking. Most people have no idea I live with cancer.
When we discovered my cancer had returned after 15 years my doctor suggested I might qualify for a clinical trial. I always thought clinical trials were the last ditch effort for sick people. My friend, a doctor said, "Participants in clinical trials receive Cadillac treatment". I said, "Well why not". After having my biopsy tested for HER2 receptors, blood work, all kinds of scans, and hundreds of questions about my general physical activity level and health, I was accepted into a clinical trial for a drug called Pertuzamaub. The treatment in a clinical trial, is regimented, exact, and time consuming. I liked instance access to the clinical trials nurse. She knew more about chemotherapy and eating than I could imagine.
I met my chemo buddy during this trial four years ago. We were both diagnosed with metastatic breast cancer. Metastatic meaning cancer has spread to the bone or other organs from the point of origin. Chemo buddy had tumors up and down her spine and in her breast. My tumor was in my sternum with some suspicious spots on other organs. Our trial was a double blind experiment. Only the trial director at the drug company and the pharmacist knew if we were receiving the drug until the trial results were released. We found out we had both received the drug. Chemo buddy is still on the trial because her tumors (no tumors evident anymore) have never progressed and she tolerates the treatments well (she still has access to the clinical trials nurse and filters my treatments through her.) We are all good friends. My tumor progressed about a year into the trial. I was removed from the trial. In the interim I received Herceptin for nearly 4 years,and had radiation. Radiation was always part of the plan,but had to be delayed until I left the trial.
In December 2013 we could no longer ignore the lump that was growing.(Still on my sternum) The idea the cancer had been contained to one site for this long encourages me.
Nonetheless, I began Adu-Trastuzumab Emtansine . This is a new drug. It was released February 2013.
To understand something about these drugs and why they are hopeful for cancer patients it is important to understand some terminology.
Understanding a few technical terms will help you understand how Pertuzumab (trade name Perjeta) and Adu-Trastuzumab Emtansine (trade name Kadcyla) work and why they are highly effective.
Antibodies: Proteins which bind to antigens helping kill or sterilize bacteria or viruses.
Antigens: Door keepers that determine what goes in and out of cells.
HER2: Human epidermal growth factor receptor type 2 proteins have been found to control tumor growth.
Chemotherapy: Drugs that are used to kill and or sterilize cancer cells. This kind of therapy can be one drug or a number of drugs used in combination. Some drugs can be taken orally and swallowed. Chemotherapy can also be intravenous, that is put into a vein. Some chemo is applied topically to the skin.
Monoclonal Antibodies: Multiple copies of specific antibodies made in the lab. The specific antibodies target the antigens attached to cancer cells to inhibit the growth or kill cancer cells of specific types.
MUGA; Multiple-gated acquisition scan is one way your doctor can determine how well the left ventricle of the heart is working
EKG: Echo cardiogram is also a test which determines how well the left ventricle of the heart is working.
In 2010 Pertuzumab had no trade name. It was in the clinical trial stage of development. At the time I was in the trial about 800 women world wide were in the trial. Today, it is on the market and is currently becoming standard protocol for treating breast cancer. This drug is a monoclonal antibody which targets antigens of the human epidermal growth factor receptor type two.(HER2). The success rate of Perjeda has been very good when used along with docetaxel (chemo drug) and Herceptin (also a monoclonal antibody) in containing and eliminating breast cancer. This combination is tolerated well by most women. While on the drug blood work is done regularly. Chemo buddy has had good blood work until a couple of months ago. She was having trouble maintaining her iron levels with diet. An iron supplement has solved the problem. MUGGA or Echo cardiograms are done at regular intervals to assure the left ventricle of the heart is functioning well.
Kadcyla (pronounced kad sigh luh) is the trade name for Adu-Trastuzumab Emtansine A monoclonal antibody. Kadcyla has a chemotherapy component. What this means is while manipulating the growth of cancer cells this drug also carries a bomb into the cells it attacks. This chemotherapy appears not to have nearly the side effects of standard chemotherapy because it attacks cancer cells specifically. Other types of chemo attack every fast growing cell (like soft tissue of the mouth and hair). I have had four treatments and the timing of the side effects is quite predictable. The pre-chemotherapy medications are not extensive as with other chemotherapy. Which means I can drive myself back and forth to treatments. So far after two months my hair is healthy , The side effects have been controlled with Zyrtec. The tumor which was visible has collapsed and is fading to nothingness. One side effect, high liver enzymes, I find somewhat disturbing. This seems to be caused by heavy exercise within the first couple of days after treatment. More scans will follow after a few more treatments. To reduce the liver enzymes to a more normal level I can back off exercising.
Eventually I was taken off this medication because my liver enzymes rose too high and my platelet count dropped too low. Platelets are the by products of the liver regulating blood clotting.
Three years later I began taking the drug again. In that time researchers learned that only moderate exercise should be attempted while using this therapy.
Would you consider being in a clinical trialSee results without voting
Tireless' Cancer Survival Philosophy
My philosophy for treating breast cancer: use the best of all kinds of treatments for the best outcome. Then live life to the fullest.
How can you live life to the fullest? Make sure your relationships are solid. Do what you enjoy with people you enjoy. Set boundaries with difficult people. The longer you have cancer the harder it is to tell people when you have set backs. Tell them, they are hurt when you don't.
Remember celebrate the good things. Be thankful for the people in your life. They helped make you who you are. Remember good friends help you be a good person. Be a good friend.
Hold on to what is important and get rid the rest.
The first breast cancer diagnoses, we attacked aggressively with chemotherapy and surgery. We did the best with what we knew at the time. I would have changed my diet significantly had I know what to do.
Four years ago after being diagnosed with metastatic breast cancer my philosophy became; get the best treatment, strengthen and develop friendships. Use alternative therapies to help stay healthy. Alternative therapies like chiropractic, massage therapy, exercise and nutrition have kept me healthy and active.
Find something to be passionate about. My mom left a legacy that thrills and delights her grandchildren. That's the kind of mother, grandmother, writer and teacher I want to be.
I don't know if these are miracle drugs. Everyone is hopeful in the oncology clinic where I am being treated.
I am still here. So come along and lets see how long tirelesstraveler keeps traveling.
This summer will be the Alaska wilderness and Israel. Look for more of my adventures in the fall.
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