neulasta

I've read while having chemo drug Cytoxan that you should not have the drug neulasta 14 days before and 24 hours after.  Is this true.

I also have a question about HER3.  What are the chances of cancer returning if you test for this.

[Fernando Roque, MD]

Hi.  The usual dose of Cytoxan being given for breast cancer (500-600 mg/m2) doesn't often cause a drastic decrease in white cell counts (called neutropenia). So breast cancer patients taking Cytoxan don't usually require drugs to increase white cell count like Neulasta.  However, if the patient has had a previous episode of neutropenia, she is at an increased risk of having another episode on her next chemotherapy.  Neulasta may be helpful in this case.  Certain chemotherapy regimens like TAC are very toxic and result in more episodes of neutropenia than the usual regimens given for breast cancer.  Neulasta should also be given in this instance.

[Fernando Roque, MD]

Hi.  Regarding your question about HER-2.  This is a test to detect the presence of human epidermal growth factor receptor type 2 in the breast cancer cells.  The presence of HER-2 indicates a more aggressive tumor type with a very high probability of recurrence, particularly if the tumor has already spread to the lymph nodes or beyond.