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ByGraceAlone 05-24-2018 02:25 PM

Less Herceptin?
 
https://www.nytimes.com/2018/05/16/h...genentech.html

This is my first time posting, but I wanted to share this article that appeared in the NY Times. I am beginning my second round of Herceptin, and my oncologist has outlined the plan to include 40 weeks of Herceptin. The first time was pre-surgery, and ran 1 week with Herceptin and 2 weeks with Taxol for a total of 12 weeks. This was all pre-surgery and I'm happy to say that I have been declared cancer free: both my pre-op MRI and my post-op pathology report found no signs of the disease.

I am fairly new to this site, and I have found that there is not much posting being done lately. If anyone wants to start up a conversation with me, please feel free to do so!

Thank you...

donocco 05-25-2018 05:23 PM

Re: Less Herceptin?
 
"Grace"

Im a pharmacist and Ill research this over the weekend. Im always skeptical about changes that save money. You start to wonder is the motivation patient safety of saving money or maybe both. Cetainly Herceptin heart damage is nothing to desregard but patients on Herceptin are carefully monitored.

Once there was a question about Subcutaneous Herceptin and I was sure it was about saving money. The research I did didnt indicate this

Paul

donocco 05-26-2018 03:53 PM

Re: Less Herceptin?
 
I found an article in the lancet that states what the other article stated. It was quite odd what the findings were. They gave about 1700 her2 positive women 2 years Herceptin and another 1700 or so one years Herceptin and the 10 year survival rate got both groups were about 69%.

Here is the oddball things. They gave about 1690 women no Herceptin for the study. Assuming they were Her 2 postitve this seems unethical. Their 10 year survival rate was 63%. It seems not only does one year = two years but no Herceptin - both for all intents and purposes. Unless I read something wrong this experiment indicates that Herceptin rherapy offers no real long term survival benefit. This doesnt make sense. Ill reread it more carefully

donocco 05-26-2018 05:08 PM

Re: Less Herceptin?
 
I printed it out to re-read it. They did start out with 3 groups of Her 2 positive women and they were planning to give one year Herceptin to one group, 2 years to another group and no Hercepotin to the 3rd. After one year there was a 46% less relapse rate in the Herceptin treated pts so all were treated with herceptin eventually. At first it seemed unethical. In this experiment with 5100 patients over 11 years the one year use 10 year survival rate was equal to the 2 year Herceptin use 10 tear survival rate. This may become the new norm considering the lesser chance of Herceptin related cardiac side effects. Only future experiments will tell for sure.

Carol Ann 05-26-2018 05:11 PM

Re: Less Herceptin?
 
I had the full year of herceptin from Nov 13-Nov 14.



Question -- were all the women in the study diagnosed at the same Stage? And I agree that getting no Herceptin at all seems highly unethical, particularly since there is historical data (before Herceptin) to indicate what none given and the resulting survival rate would be.


Carol Ann

donocco 05-26-2018 09:51 PM

Re: Less Herceptin?
 
Carol Ann

The short article in the Lancet didnt mention stage but Ill research it further. The non Herceptin group did get the Herceptin after the first year so eventually all of the 5100 Her 2 positive patients got the drug The ethical question is did the pts who did not receive the Herceptin for a year realize this? Herceptin was approved around 2000 so its benefits were very much known. Why a pl,acebo group?

Oncologists tend to be ultra conservative as I perceive them in the literature I read. I cant imagine the majority of them halving the duration of Herceptin therapy based on one study. Unless there is economic pressure being put on them. How does your oncologist feel about this?

Carol Ann 05-27-2018 02:09 PM

Re: Less Herceptin?
 
Our posts must have just crossed each other!



I have my next, every 6 month appt with my oncologist next month (15 June) I will ask him what he knows about this, etc.



Thanks for posting back so quickly!


Carol Ann

ByGraceAlone 06-04-2018 07:31 AM

Re: Less Herceptin?
 
Donocco & Carol Ann

Thanks for your responses.


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