Out of the Loop...Not So Fast
 

So I thought I was safe on the sidelines of the breast cancer war. Ha! So much for the "vacation". I stopped a week ago to visit a couple that I have been friends with since the 70's. I hadn't seen them in years. As I sat chatting with my transplanted friends from communist Hungary, the woman calmly announces to me that she has breast cancer. I was stunned. She asked me if I knew anything about it, and I said that I did at one time but hadn't been keeping up on it like I used to when Mom was battling it. We discussed her case a little, and I offered to go with her to see a surgeon a discuss a plan of treatment. Little did I know what I was in for.

We travelled to the University of Pennsylvania, specifically the new Rowan Breast Center. I had not been anywhere near the U of P since Mom got her wings, and I felt my anxiety going up the closer we got. The new center is nothing short of spectacular. It is well thought out and even has parking in the same building. Imagine that. In Philadelphia, parking in the same county as the destination is a rare thing. This facility is nothing short of a state-of-the art, one stop diagnostics and treatment center for breast cancer. Women in this area will benefit greatly from this place.

The best was yet to come. We sat for quite a while in a spacious waiting room, and then were summoned to see the doctor. He went over the pathology with my friend, who after all these years still struggles a little with the many oddball subtlties of the English language. He told her that she had an unusal type of breast cancer. He calmly told her that her cancer was known as a HER2+3, Er-/Pr- cell type. My mouth dropped open. You have got to be kidding me, I thought silently. Some weird thoughts raced through my head, including Al Pacino's line in Godfather III where he says, "Just when I thought I was out, they pull me back in".

The lengthy conversation that followed with this remarkable man, was nothing short of fascinating to me. I suspect that the things I learned next are nothing new to all of you guys, as you have all been up to date on the latest toys and strategies for battling the Beast. But the things I heard over the next thirty minutes were stunning.

The surgeon's name is Dr. Brian Czerniecki, and he is running the clinical trials on a vaccine for early stage HER2. The wonderful conversation I had with this unassuming, arrogance-free physician left me ever so hopeful for my friend as well as all of you. Despite his casual bedside manner and willingness to go way beyond the extra mile in explaining these complex details to his patients, this man is clearly passionate and totally obsessed with succesfully developing an effective vaccine for HER2 cancers. From what I have heard so far, he and his colleauges are well on their way to making history in the treatment of breast cancer.

Patients in the trial undergo plasmapheresis at the beginning of the treatment, having their own immune cells sensitized to produce an immune response to HER2. After the initial series of administrations of the tailored vaccine, the patient undergoes their surgery, and is susequently followed up for an extended period of time.

I won't go into the details of my friend's plan until she has decided exactly what route she is comfortable with and gives me the OK to openly discuss her case on this forum. I will simply say that another little miracle took place yesterday, and gave me one of the small moments of the happiness I have missed since Mom passed away. I will try to write when I can and let you know what's going on. Take care all, and remember that I think (and worry) about all of you on this website every day.

Sincerely,
Tom

Thanks for sharing the amazing story, Tom. Do keep us updated with the Her-2 journey of your friend. Perhaps she will join the board sometime soon?

Tom,

You are a very thoughful person to accompany your friends to their doctor's appointment. I did not join this board until February 2008, so I don't know anything about your mom. You sound like a wonderful and caring son.

The vaccine trial sounds really interesting. Please let us know about the treatment plan she decides to take. She will be in my prayers.

God Bless You for helping them.

Amelia

Tom old friend...
 

your friend is LUCKY (to say the least) to have someone as supportive and knowledgeable as you in her corner. I strongly feel your mother guided you to her. I know life goes on after cancer, but please just pop in to say "Hi". HUGE hugs and I'm tickled about hearing from you again (though it stinks your friend is going through this). Take care and God bless.

Good to "see" you again, Tom! I well remember you and your Mom. How lucky your friend is to have you to confide in for support. After all, support is the key when we are feeling crazy with this disease.

Tom,
If the trial is public, please post info when you get a minute. Here is an interview from '05 which sounds related:
http://www.oncolink.org/types/articl...&ss=36&id=9500

..and a follow up on pubmed from '08:
1: Immunol Rev. 2008 Apr;222:256-76.http://www.ncbi.nlm.nih.gov/corehtml...nce_150x34.gif Links
Reengineering dendritic cell-based anti-cancer vaccines.

Koski GK, Cohen PA, Roses RE, Xu S, Czerniecki BJ.
Department of Immunology, Center for Surgery Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Despite initial enthusiasm, dendritic cell (DC)-based anti-cancer vaccines have yet to live up to their promise as one of the best hopes for generating effective anti-tumor immunity. One of the principal reasons for the generally disappointing results achieved thus far could be that the full potential of DCs has not been effectively exploited. Here, we argue that dramatic improvements in vaccine efficacy will probably require a careful re-evaluation of current vaccine design. The formulation of new strategies must take into account the natural history of DCs, particularly their role in helping the immune system deal with infection. Equally critical is the emerging importance of soluble factors, notably interleukin-12, in modulating the quality of immune responses. Vaccines should also be designed to recruit helper T cells and antibody-producing B cells rather than simply cytotoxic T lymphocytes. Finally, the judicious selection of tumor, target antigen, and disease stage best suited for treatment should serve as the foundation of trial designs. Our discussion addresses a recent clinical vaccine trial to treat early breast cancer, where many elements of this new strategy were put into practice.
PMID: 18364007 [PubMed - indexed for MEDLINE]

Rich,

Here's the link to the current HER2 vaccine clinical trial at U of P.

http://clinicaltrials.gov/ct2/show/N...3=NA%3AUS%3APA

Here is the NCI link as well.

http://www.cancer.gov/clinicaltrials/UPCC-15107