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10-24-2005, 01:08 PM

Hi fellow decision makers-

I was dxed with Stage IIB, Her 2+++, ER+(weakly), PR-, three positive lymph nodes in Feb 04. Had standard 4 doses AC(before I switched oncologists-wish I had been given dose dense) and then Taxotere every 3 weeks and Herceptin every week for 12 weeks.(was not in a clinical trial). Also had 28 weeks radiation, started Arimidex and had one year of Herceptin. Am just starting a second year of Herceptin. (I will continue routine MUGA scans to monitor my cardiac status/LVEF which has stayed in the low 50s). I had decided that I would rather be ahead of the HERA trials rather than behind although I am fully aware that the final results may not show a statistical difference in disease free/overall survival in those who took one year vs two years in that particular study.

I found an interesting statement by Dr. Edith Perez from the Mayo Clinic in an online interview: http://www.medscape.com/viewarticle/506111

Moderator:"How did you choose to study one year of trastuzumab instead of a shorter or longer duration of study?"

Dr. Perez:" We could have selected 6 months but based on preclinical models we knew we had to use it for a long time. We felt that if we required 2 years of therapy, we might run into problems with compliance. We felt that 6 months might be an insufficient duration but it was a somewhat arbitrary decision. We are currently working on a new clinical study to evaluate the optimal duration of therapy."

I greatly respect the value of clinical trials and their use in evidenced based clinical decision making. On the other hand, as a sample of one, I am pleased that I have an oncologist willing to cautiously proceed in an individualized trial with me and am comfortable with my current decision to go for the two years.

Best wishes to all who are engaged in these ongoing, personal, and sometimes complicated decisions.

10-24-2005, 01:08 PM	#12
Unregistered Guest Posts: n/a	Hi fellow decision makers- I was dxed with Stage IIB, Her 2+++, ER+(weakly), PR-, three positive lymph nodes in Feb 04. Had standard 4 doses AC(before I switched oncologists-wish I had been given dose dense) and then Taxotere every 3 weeks and Herceptin every week for 12 weeks.(was not in a clinical trial). Also had 28 weeks radiation, started Arimidex and had one year of Herceptin. Am just starting a second year of Herceptin. (I will continue routine MUGA scans to monitor my cardiac status/LVEF which has stayed in the low 50s). I had decided that I would rather be ahead of the HERA trials rather than behind although I am fully aware that the final results may not show a statistical difference in disease free/overall survival in those who took one year vs two years in that particular study. I found an interesting statement by Dr. Edith Perez from the Mayo Clinic in an online interview: http://www.medscape.com/viewarticle/506111 Moderator:"How did you choose to study one year of trastuzumab instead of a shorter or longer duration of study?" Dr. Perez:" We could have selected 6 months but based on preclinical models we knew we had to use it for a long time. We felt that if we required 2 years of therapy, we might run into problems with compliance. We felt that 6 months might be an insufficient duration but it was a somewhat arbitrary decision. We are currently working on a new clinical study to evaluate the optimal duration of therapy." I greatly respect the value of clinical trials and their use in evidenced based clinical decision making. On the other hand, as a sample of one, I am pleased that I have an oncologist willing to cautiously proceed in an individualized trial with me and am comfortable with my current decision to go for the two years. Best wishes to all who are engaged in these ongoing, personal, and sometimes complicated decisions.