Next up ...Taxol

I saw Dr G yesterday and we had a long discussion on what treatment I should take next. We talked about the results of the recent annual San Antonio Breast Cancer Symposium. The most interesting part to me was the research on Afinitor, a drug which is supposed to increase the effectiveness of aromatase inhibitors. I'd really like to try this combo, partly to get off chemo and partly because my very estrogen-sensitive cancer responded well for seven years to these drugs.

Bloomberg BusinessWeek reports:

In a second study, another drug long used in organ transplants but not tried against breast cancer -- everolimus, sold as Afinitor by Novartis AG -- kept cancer in check for a median of 7 months in women whose disease was worsening despite treatment with hormone-blocking drugs. A comparison group that received only hormonal medicine had just a 3-month delay in disease progression.

Afinitor works in a novel way, seems "unusually effective" and sets a new standard of care, said Dr. Peter Ravdin, breast cancer chief at the UT Health Science Center in San Antonio. He has no role in the work or ties to drugmakers. Most patients have tumors like those in this study -- their growth is fueled by estrogen.

So Dr G will start the wheels turning with my insurance company to see if Premera  will approve Afinitor for me. it's extremely expensive -- up to $10,000 a month -- so who knows?

Another finding indicated longer toime until disease progression with two aromatase inhibitors, anastrozole (Arimidex) and fulvestrant (Faslodex). I've taken both of these, but never together. I did try the high-dose Faslodex reported last year, and it was not effective, so we're not sure if this will help me or not.

MedPage Today reports:

"Over the years, our treatment approach for such women with metastatic breast cancer has been sequential use of as many hormone therapies as possible, keeping metastatic disease under control for as long as possible. These findings may allow us to change our approach. In this group of heavily pre-treated patients, all of whom progressed on prior endocrine therapy, the addition of this mTOR inhibitor resulted in significant prolongation of progression-free survival and an improved response rate, with only a modest addition of toxicity," said Hortobagyi.

In the end, we decided to go ahead with Taxol, a chemotherapy related to the Abraxane I've been on since last April. It's actually the same drug, delivered in a slightly different manner. You can read more about Taxol here.

I ought to tolerate it as well as the Abraxane. It's given weekly, and at least at first with Benadryl (to prevent an allergic reaction) and with steroids (to ease the reaction). Luckily, Rik is off for school vacation these next two weeks, so he will be able to drive me, etc. since the Benadryl will prevent me from driving myself. Then I see Dr G in the first week of January. If I tolerate the Taxol, I'll continue on it. If not, we will see what we will see. He's got a lot of tricks in his pockets.