Herceptin for noninvasive CA?/trial?

[sunny Lisa]

Hi All, Has anyone heard of receiving Herceptin when nodes are neg. and no microinvasion was found? I had a 9cm toumor (DCIS insitu) removed by mastectomy and left with positive margins. I will start radiation but I would feel better if I had some systemic treatment to prevent reoccurence. I am ER neg. so Tamoxafin is out or may help minimally?
Has anyone else been in this situation and if so what were your treatment options? Are there any clinical trials? Thanks, Lisa

[Lani]

1: Breast J. 2007 Jan-Feb;13(1):72-5.
Novel clinical trial designs for treatment of ductal carcinoma in situ of the breast with trastuzumab (herceptin).

Gonzalez RJ,
Buzdar AU,
Fraser Symmans W,
Yen TW,
Broglio KR,
Lucci A,
Esteva FJ,
Yin G,
Kuerer HM.
Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
Because ductal carcinoma in situ (DCIS) avidly expresses Her2/neu, the target of the monoclonal antibody trastuzumab, and because trastuzumab has been shown to be effective against invasive breast cancer, trastuzumab may be effective for reducing the tumor burden and abrogating or reversing the hypothesized transition from in situ to invasive disease in patients with DCIS. To test this hypothesis, a trial of neoadjuvant trastuzumab for DCIS has been opened at our institution. Because trastuzumab has been shown to act as a radiosensitizing agent for Her2/neu-overexpressing cancer and because there are currently no systemic treatments for estrogen-receptor-negative DCIS, it makes sense to investigate whether use of trastuzumab concurrently with postoperative radiation therapy improves local control of DCIS. The National Surgical Adjuvant Breast and Bowel Project (NSABP) is planning a trial to test this hypothesis. The risk of cardiac toxicity associated with the doses of trastuzumab planned for these trials (cumulative doses of 8 mg/kg for our trial and 14 mg/kg in the NSABP trial) is believed to be minimal, but the safety profile of these approaches will need to be closely monitored.
PMID: 17214797 [PubMed - in process]

[Bev]

Lisa, See if you can get an oncotype dx test paid for. Then get 2nd opinions. I would think doing Herceptin would be a good choice. BB

[sunny Lisa]

Thank you both for the good info. I will be getting a second opinion from Dr Elisabeth McKeen in West Palm Beach. Mayo clinic in Jacksonville said no to Herceptin and my local oncologist just thought it was absurd but it seems to be the only choice. I found out my margins were very positive, CA still in the deep margins. Lisa