Herceptin: 9 weeks vs. one year
 

I attended the Era of Hope Breast Cancer Conference last week and Dr. Slamon was briefly explaining away the Herceptin story... The one thing that really got me was that when Herceptin was first used, no one knew (still don't) what length of time should be prescribed... so the biotech people suggested "One Year" and so it went.
For the 9 week trial in Finland... Well, the Finnish gov't was only able to afford enough Herceptin for 9 weeks... and so it went.
Just goes to show how nebulous EVERYTHING is regarding cancer treatment !

Maria

oh boy- news you would rather not hear. by the way, did Dr. S. discuss his thoughts on how much Herceptin would be ideal (based on current knowledge) and why?
karen

Very interesting. Before people get confused, I would just like to point out that that nine weeks involved herceptin given with a taxane before an anthracycline chemo, not just nine weeks of herceptin.

When I was going through treatment 2.5 years ago my onc had the opinion that 9 weeks with a taxane was the most important part of the treatment and the 1 year of followup herceptin was purely a money maker for the drug company. Mind you this was just her opinion and she was clear on that due to no studies at the time of the 9 week trial. Having told me that she did let me continue on herceptin until it affected my heart due to the fact that it was the standard of care at the time.

Here's some info on the Finnish study from the NIH:

http://www.cancer.gov/clinicaltrials...in-cardiac0306

And an abstract from an article on the trial that appeared in the NEJM:

http://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Abstract

A Finnish point of view
 

Mts wrote:

"For the 9 week trial in Finland... Well, the Finnish gov't was only able to afford enough Herceptin for 9 weeks... and so it went. "

This is more or less rubbish. Naturally 9 weeks treatment is less expensive than one year, but the main fact is that we are looking for the optimal treatment of bc. New trial is going on, please visit:

http://www.druglib.com/trial/97/NCT00593697.html


Besides, the normal duration of taxane treatment is nine weeks in Finland. The point of FinHer study was, should we start Herceptin with Docetaxel or Vinorelbine. The decision to continue with Herceptin is always available. The vast majority of finnish HER2 patients are comfortable and safe with 9 weeks of Herceptin.

The context of Dr Slamon's speech was to reflect on how the initial timetable for Herceptin use came about... he did not mean it as a joke - just pointing out the nebulous realm of cancer treatment. Obviously the other tandem drugs were part of the mix. Hence the trial.
Most of us (including myself) had it for a year.

The point being made is that no matter the length, there is still no "mark" on when to end Herceptin tx --of course cardio issues are a telling part---
My feeling is that as long as it shows a benefit- then keep on!

maria

I consulted with Slamon and he told me the same thing....no time specific time frame for giving herceptin has been established by studies yet. So the one year time frame is completely arbitrary in his opinion. I think his point was that if I had to stop herceptin early due to cardiac issues that I shouldn't be worried as probably taking it for some time frame less than a year may work just as well. He even mentioned the FinHer study to me.