Music to your ears....Dr. Sledge's prediction on her2+ breast cancer
 

J Community Support Oncol. 2014 Mar;12(3):78-81.
Is the era of HER2 over? Pertuzumab in the neoadjuvant treatment of early HER2-positive breast cancer.
Samuel TA1, Stone E.
Author information

Abstract
At the ASCO Breast Cancer Symposium in San Francisco last year, the keynote speaker, Dr George Sledge, chief of oncology at Stanford University School of Medicine and a preeminent breast cancer researcher, gave his 5 predictions for the state of breast cancer care in 10 years. One of his more startling predictions was that in 10 years, he believed that the era of HER2/neu would be over. He predicted that 3-year disease-free survival for patients with HER2/neu-positive disease would more than 92%, approximating outcomes in other good prognosis malignancies such as testicular cancer. In view of that expectation, he believed that the main research questions regarding HER2- positive disease would eventually involve decreasing toxicity and costs rather than the improving efficacy of HER2-targeted therapy. Essentially, HER2/neu-positive disease would cease to be a public health issue. In view of this remarkable but likely prescient statement, we note the recent publication of 2 trials (NeoSphere and TRPHAENA) that examined the efficacy and safety of the use of pertuzumab in combination with trastuzumab and chemotherapy in the neoadjuvant treatment of early-stage HER2-positive breast cancer.
PMID: 24971410

Re: Music to your ears....Dr. Sledge's prediction on her2+ breast cancer
 

I wish they would look farther than 3 years out. There are many women who are diagnosed with mets later than 3 years, myself included. I would be included in this impressive 92%, yet it means little at this point.
I hope this doesn't mean an end of new treatment options for those of us ( and the future women) who have mets.

Laurie

Re: Music to your ears....Dr. Sledge's prediction on her2+ breast cancer
 

Laurie: ditto.

Re: Music to your ears....Dr. Sledge's prediction on her2+ breast cancer
 

I was a bit shocked at this post. If this is the attitude of the leading researchers, then we need to find new researchers that strongly believe cancer patients should be cured and live for decades. If a 92% survival rate for 3 years is considered acceptable by the individuals that we support with huge funding for cancer research - well I can only borrow a phrase from Donald Trump "You're Fired!"

The era of focused Her2 neu research seems to be winding down significantly. We have been lucky enough to be the golden girls of breast cancer research for decades.

I strongly applaud treatments with reduced toxicity, but expect much more.

I am eagerly waiting for the results of the Neuvax trial that had a subgroup of Her2 low expressors who had 100 percent Disease Free Survival for 48 months and 94 percent for 60 months in a Phase II. This is the results that we as survivors want.

92 percent for 3 year survival is unacceptable.

Re: Music to your ears....Dr. Sledge's prediction on her2+ breast cancer
 

I suspect this is just a badly framed announcement. I'm sure Dr Sledge is as eager for long term survival for HER2 breast cancer patients as we are. He's thinking about the natural history of the disease and the way in the past it took people rapidly and used the 3 year figure (because that's from a recent study and longer term data on Perjeta etc isn't out yet). I think it was a rah-rah "isn't it great what's been achieved, let's keep going" message to inspire the symposium delegates, rather than a "that's good enough - move on to other diseases now" message.

Aussie Girl

Re: Music to your ears....Dr. Sledge's prediction on her2+ breast cancer
 

I agree about the longer than 3 years outcome...however, this is still a mighty fine tune and I am singing along!!

Re: Music to your ears....Dr. Sledge's prediction on her2+ breast cancer
 

Music??? To my ears this is a symphony! Thank you Lani for sharing another good tidbit.

Re: Music to your ears....Dr. Sledge's prediction on her2+ breast cancer
 

Are we talking stage III and IV? Because these numbers do not make sense. The survival statistics for stage I and II was already in the mid to high 90s for 5 years prior to neoadjuvant TCHP.

Is it acceptable that 8 of each 100 women diagnosed will be dead in 3 years?
What if you are one of the eight women? Too bad, so sad?

While I applaud the advances from the TRPHAENA and neoSphere trials, I'm extremely uncomfortable with Dr. Sledge's statements.

However, I'm sure there are other researchers out there who strongly believe in building on the advances in Her2 research and also feel there is no acceptable death rate from cancer.

Re: Music to your ears....Dr. Sledge's prediction on her2+ breast cancer
 

3 years: Ned
4 years: Stage IV.... I hope Dr Sledge doesn't think this is a success.

I have the uncomfortable feeling that with Herceptin, Tykerb, Kadcyla and Pertuzumab many research centers are happy. But we know here that we still need more options.

Re: Music to your ears....Dr. Sledge's prediction on her2+ breast cancer
 

On the one hand, I do appreciate the positive outlook. On the other, I share the concerns others have expressed.

Of course, a substantial number of HER-2 cancer patients are metastatic from day one. I've known several in that category who were diagnosed a very short time after "clean" mammograms. So even a good treatment is not good enough. We need prevention.