New Zealand says 12 months of Herceptin is a "Bad Investment"

[alicem]

Alright ladies, I'd love to hear your thoughts about this:

"Herceptin spending 'a bad investment'
Millions of dollars spent on 12-month Herceptin courses for breast cancer sufferers is a bad investment, women's health campaigners say. ... Read More here . . . http://www.stuff.co.nz/national/health/3184288/Herceptin-spending-a-bad-investment"
How many of you would have volunteered to take less Herceptin in a clinical trial?

[Colleens_Husband]

New Zealand had a huge political brawl to get Herceptin funded in the first place. It is an expensive drug and if you look at the calculus of lives saved versus cost, Herceptin doesn't compare very favorably versus heart drugs or stroke medication. The only thing is that in order for the formula to balance, you need to put a dollar figure on the value of human life. Would anyone here care to give a price on what their life is worth?

This is what happens when health care is politicized.

[Becky]

I think the first thing will be the final results of the HERA trial where women received either no Herceptin, one year of Herceptin or 2 years of Herceptin. The Herceptin was given after chemo (within 6 months of chemo completion) and any type of chemo could have been used. Criteria was node positive or a tumor was that was greater than one centimeter.

The interim results of one year Herceptin vs no Herceptin was equal to the USA study of combining with AC followed by TH or TCH. Although the USA study of concurrent with chemo vs sequential (after chemo) says that with chemo is better (5 yr interim given at SABCS says 34% reduction with chemo vs 30% reduction without chemo).

HERA study's "same as" results is MOST likely due to the fact that there was no standardized chemo regime so you are seeing that chemo that is considered inferior for Her2+ (like CMF for example) was considerably "upgraded" for Her2s.

That said, the 1 yr of Herceptin vs 2 yrs of Herceptin results for the HERA trial have not been released yet. It has been a long, long time so I think there were not any upfront superior results to report. Perhaps long term, there will be better results for 2 yrs but everybody in the know (like Dr. Eric Winer) do not think the results for 2 yrs will be any better. If that is true, then one has to wonder if 6 months of Herceptin is just as good as 12 months. After all, 15 to 20 years ago, women received AC (adriamycin and cytoxan) once a month for 12 months and then in trial found that 4 cycles 3 weeks apart was just as good.

Certainly if 1 yr is just as good as 2 yrs, it begs the question if 6 months is as good as 12 months. However, it will be extremely difficult to trial that to a woman with Her2 bc. Another way to evaluate this is to look at women who had to stop Herceptin because of low muga/echo. Even on this board we know of women who had to stop Herceptin early. Those women should be analyzed mega big time and how their recurrence rates stack up against those who could take the full year (just thinking out loud here). That would be interesting to see for sure.

[hutchibk]

I ❤ Lee. And would like to restate that "I would rather be anecdotally alive than statistically dead." (Having been on Herceptin on and off for 4+ years now in different combinations, I am thankful that I haven't been relegated to a mathematical financial formula, yet.)

[Midwest Alice]

Hey Becky, How are ya? How about a study of taking Herception for 5 years like our counter parts that are ER+. They take the treatment/pills for 5 years.

We have many who have been on Herception for years.... I think it could be that more is better. Or years could be better. This will take time to know.

[Diane H]

Like very much the idea of taking a look at those who had to stop
due to cardiac difficulties. Great idea Becky.