For those who couldn't complete treatment due to Cardiotoxicity
 

I know that this issue was discussed here several weeks ago. I found this interesting information this morning:

FinHer study

The data on the 116 patients in the FinHer study is for 3 years of follow-up and reveals that short duration concurrent treatment with Herceptin is effective at preventing recurrence of disease. In
Finland both the 52-week course of concurrent treatment with Herceptin and the 9-week course are available to women. However Finnish doctors prefer the 9-week course because there is less likelihood of cardiac damage and because the doctors were involved in the FinHer trial and saw for themselves the benefits to their patients of the 9-week course. This experience makes a big difference when doctors are making recommendations to their patients on best treatment options.
Sledge study

The data on the 227 patients in the Sledge study is for 5 years of follow-up and it showed no difference in survival rates between those who received 10 weeks of concurrent treatment with Herceptin and those who received it concurrently for 52 weeks.It is obvious that the issue of concurrent treatment with Herceptin versus sequential treatment is at the core of this debate. The results of these studies revealed that concurrent treatment with Herceptin results in significantly better efficacy than sequential treatment with the drug, all of which casts grave doubts on the superiority of the sequential treatment regimen being promoted by Roche.... A further trial is being planned to find the answers. It will be headed by Professor Heikke Joensuu of the University of Helsinki in Finland, who headed the FinHer trial and who has extensive international experience in trial design and management.

Regards
Joe

I am having a brain poot - what are the conclusions?

The conclusion was that there was no great difference in results whether Herceptin was given over a short period 9-12 weeks or 1 year.

Regards
Joe

So what about those of us who received herceptin sequentially and had to end treatment early due to cardiotoxicity?

Paris

My take on this
 

I have been one of those people inquiring recently on this issue because my sister was taken off Herceptin last week after 6 months of treatment.

Joe was kind enough to give me the same info as posted here, and my take on this is that the chance of my sister having a recurrence is no more increased because she can't get the full 52 weeks.

Joe, any idea what Dr. Slamon's take on the FinHer study is?

BonnieD

No doubt that I will see him in San Antonio, if I can get his ear, I'll ask him.

Regards
Joe

OK, help me understand. It seems the CONCURRENT piece is the important one here. Does that mean concurrent with Taxol, or other chemo, or what? For example, those of us who took AC, then Taxol/Herceptin...is that the protocol they suggest is good, or does it mean starting Herceptin even earlier??? Thanks for sharing this info with us, Joe.

Thanks for posting this. My onc recently stopped Herceptin after 7 treatments because of low Muga score, and he told me about this finding and doesn't feel that I need to go back on it now even when the score improves.

It's nice to get a second opinion like this after all of the data that has been presented on a full year of treatment.

I admit that I was questioning in my mind if the oncologist was right after all of the info that I've learned from this board!

Can Herceptin be re-started
 

Does anyone know that once you are removed from Herceptin because of Cardiac issues, can it ever be restarted if the need is there, provided of course the heart issues have corrected itself?

Or once removed, that's it??

Bonnie

Bonnie, Yes, if all issue's with the heart is resolved herceptin can be started again with no problems most of the time. Usually after a break from herceptin they will check the heart with a muga and if its 55 or above you can usually start back on it.

Chelee

Bonnie,

I had to come off Herceptin last year for about three months.

My left ventrical ejection fraction dropped by more than 10 percentage points (from 70% to 57%), which is a guideline for stopping Herceptin even though I wasn't under 50%, the lower limit.

After a while my LVEF went up again to 63% and has stayed there since.

I've switched from muga scans to an echocardiogram, and had an echo the other day.

Joe,

Although this might sound "crazy," can you ask Dr. Slamon whether he thinks that the Finnish gene pool is small enough to affect the outcome trials. I would imagine that despite worldwide migration, etc., that the gene pool in Finland is small, relatively speaking, and I've always wondered what kind of influence this might have had on the FinHer trial.

Joan

Appreciate the feedback
 

I really appreciate all of your feedback. Very encouraging to find out that if necessary, Herceptin can be started again.

Joe, thank you so much for your comment, if you can get Dr. Slamon's ear. When are you going to San Antonio?

This site has been wonderful. My sister has a really hard time getting past the Her2 status, so when I tell her the positive feedback I get from this site, I can tell each time she gets a bit more hopeful. Right now she is just trying to focus on staying well and taking care of 4 very active children (ages 5,10,12 & 13) who are in every sport imaginable, so I try to be the researcher in the family, and with the help of some many wonderful people here, we have learned so much!

THANK YOU!!!

Bonnie