Visit with Dr. Rubin

Dr. Rubin gave me some prescriptions for pain, nausea, and a numbing cream to use over my port an hour before chemotherapy.

I officially "signed up" for a clinical trial and will find out tomorrow what group I will be in. Group 1 is "standard" treatment and uses AC (doxorubixin and cyclophosphamide), Taxol and Herceptin before surgery. Group 2 uses AC, Taxol and Lapatinib before surgery. Group 3 uses AC, Taxol, Herceptin and Lapatinib before surgery. All patients will use Herceptin. However, group 2 only uses Lapatinib before surgery but follows with Herceptin after surgery. I'm hoping to be randomly picked for group 3 so I can have both Lapatinib (the drug they are studying) and Herceptin before surgery.

HER2-positive breast cancer means that my cancer makes too much of a protein called HER2. The overproduction of this protein can cause normal cells to pick up too many growth signals which can turn a normal cell into a cancer cell and can change the way a cancer cell responds to treatment.

The study is being done to test Lapatinib (AKA Tykerb) which is a new therapy for HER2-positive breast cancer. Where chemotherapy drugs, like AC, work by directly killing cancer cells, Lapatinib is a "targeted" therapy. Targeted therapies work by blocking or interfering with a specific part of the cancer cell to slow down or stop the tumor from growing. Both Lapatinib and Herceptin are targeted therapies but Lapatinib works inside the cancer cell to block the HER2 protein and Herceptin blocks the receptors on the outside.

I asked if there were any clinical trials for PARP Inhibitors. ("PARP inhibition has the potential to impair a fundamental mechanism of tumor growth without rendering damage to normal cells, implying a lower risk for side effects in patients who receive PARP-inhibitor-based therapies." See http://www.biparsciences.com/000010.html for more information.) But, the only study that almost fits my description is for triple negative breast cancer patients. I wish there were a PARP inhibitor clinical trial that my diagnosis could match. But, Dr. Rubin said that Herceptin is a terrific drug.

Before leaving, Dr. Rubin sent me to the labs to have more blood drawn. He wants to test and confirm that I have thyroiditis. This test will take 1-2 days to get back.