using SABCS

[jeff]

Hi all,

I realized there are about six different topics I wanted to post under and thought maybe I'd just start a new thread rather than do that.

There is so much information to digest from SABCS that I just wanted to offer what is probably an obvious hint. If you go to sabcs.org and register (no $ or anything, just have to give some info) you can then search their online database of all the abstracts that were just presented last week. The great thing, I find, is that you can search by keyword: for instance if you type in "her2" you get 78 hits, and find abstracts ranging from the most basic (way above my head) bench science to the most obvous all-you-folks-know-this-already confirmation of what's happening in practice.

If you type in "vaccine" you'll get a handful of hits...

If you are interested in attempts to target more than one pathway try typing in "trastuzumab" and "gefitinib" or "her1" and "her2" or something like that. There is info that the combo herceptin/iressa was a washout. But there is more hopeful stuff about other targeted therapies like pertuzumab and erlotinib. Also, look up lapatinib (572016) and you'll find a few things too...

For those of you interested in complementary and alternative approaches, there was even one promising abstract about IP6!

As some of you have noted there is no info yet on the adjuvant trials. But if you type in "neoadjuvant" you will find some stunning info, inlcuding one small trial where neoadjuvant chemo + herceptin resulted in something like a
75% complete response rate. Some folks think complete response rate in neoadjuvant trials corresponds with ultimate overall survivall, so this is really good news.

Don't know if all this muddies the waters more, but I've found it a helpful way to navigate through all the news...

Hope you all are well today. Yesterday marked Rachel's two year anniversary from time of her original diagnosis!

Best,
Jeff

[Audrey]

Thanks Jeff for the information on navigating the San Antonio results. I was getting discouraged that I couldn't find more positive info. about Herceptin, but you gave me some other searches to try that might be helpful, including the stuff about complementary/alternative therapies...Congrats to Rachel on her 2-year anniversary. I celebrated my 3 1/2 year anniversary of my diagnosis recently as well as my 39 1/2 birthday--only 6 more months until I turn 40--a goal I'd never thought I'd reach after my diagnosis at 36... my prognosis was terrible, but I really think the adjuvant Herceptin really helped me...hope the clinical trial study results are announced at San Antonio next year and they are so positive that they start treating Her2+ women with Herceptin immediately, instead of waiting for the cancer to spread...Anyway, thanks again for the helpful hints.. Audrey

[Lolly]

Thanks, and Congratulations to Rachel and you for the anniversary! That's a great milestone, and here's to many more!

Love, Lolly

[Merridith]

What does "Neoadjuvant" mean?

Merridith

[*_Christine_*]

Jeff and Rachel
We need more posts like yours to carry the ball on our website. Thankyou Jeff for your valuable info from time to time
I personally want to congratulate Rachael's 2year anniversary, She can be proud to say she is a SURVIVOR! Keep it going!
Hugs to you both

[al from canada]

Hi Jeff,
Congrat's on Racheal's continued success.
I typed in IP6 in the SABCS search and nothing came up. Cab you help me out?
Thanks,
Al

[jeff]

Thanks, all, for the kind wishes. We had a great dinner out (with no kids!) to celebrate.

Now, to answer the two questions I've seen above

1. neoadjuvant just means chemo given before surgery. It's becoming more and more common, and it seems like these herceptin trials were developed by docs who were just looking for a way to get herceptin to women without waiting for the adjuvant trial results. One of the good things about neoadjuvant chemo is that you can immediately track the results--at least somewhat: if the lump disappears, or at least shrinks, you know you're responding to the meds.

2. Yeah, it's hard to find the IP6 abstract because the 6 is written as a subscript. Just type in the word "inositol" and you'll find it.

Best to all. This board has been utterly crucial to me over the past two years.

Love,
Jeff

[*_Vicki_*]

"Neo" means new or most recent and "adjuvant" means a substance adminsitered with and enhancing the action of a drug or antigenic substance. An antigen is anything that elicits an immunological response. For example Herceptin is a new agent that is believed to have a a synergistic effect when used with other chemo agents such as adriamycin and the platins. Herceptin is also a monoclonal antibody which specifically targets and binds with HER2.
Regards,
Vicki

[*_anne_*]

Hi ,

I read your exciting news about the neoadjuvant chemo + Herceptin. How do they think that good response initially will mean the person will be cured and what difference is it in a person having just adjuvant therapy if the same drugs are used? The thought of leaving the cancer in your body one additionaly day after it has been found, even if chemo is giving sends me chills.

[jeff]

Hi Anne,

I'm not sure if I undertand your question but I'll take a whack at it anyway. In clinical trials there are a number of different categories researches use (for instance "overall survival" "disease free survival" "time to progression" ). Most clinical trials for breast cancer, if I'm not mistaken, are in the metastatic, where the key categories have to do with extending life, pure and simple. But in the neoadjuvant setting that's not exactly a relevant category: so researchers look for "surrogate" markers. "Complete response"--i.e. the tumor and any palpable lymph nodes disappear--is taken by some docs as evidence that disease has been eradicated, though it's not exactly proveable. Likewise, there are plenty of people who think that the neoadjuvant success with herceptin indicates that the results of the adjuvant herceptin trials will also be good ones. Herceptin is not good at treating very "bulky" disease, so the idea is to use it when it can do its best work.

As for your second point, if I understand it, there is something psychologically and emotionally compelling about treating the primary first through surgery: the "just get it out" urge. But there's lots of evidence that treating first systemically is more important that addressing the issue of the primary tumor.

Hope this helps.

Jeff