[phil]

I am already a big fan of t dm-1 ( kadcyla) as it was the drug that finally worked for my wife , after many chemo / herceptin combos (7 or 8 ? ) that did not. after 4 yrs of steady progression on other chemos, 2006 - 2009 , we got t dm-1 in expanded access starting in nov. 2010. her cancer was gone by oct., 2011 , even after reducing dose at dose 8 to 3.0. had been ned since. stopping all tx. in 2014. we never got pertuzumab as it was not approved until 2012 , and then only for earlier stage disease .
i think in the future t dm-1 will be deployed earlier , esp. for those like my lorraine who are strongly overexpressing her2 only ( no other hormone factors) , metastatic at dx. she was a 6 on the FISH scale. t dm-1 and pert. together for pts like her. avoiding the nastier hair loss, mouth sore chemos like taxotere.
interestingly in the editorial by dr. vogel. not sure if it's the same dr., but there was a dr. vogel writing for oncology news , an on line journal , who was a major skeptic of t dm-1 during the 3 yrs that the FDA denied early approval. i remember that dr. vogel as he was one of many in those yrs , who had no direct work with t dm-1 but felt free to air ignorant opinions. saying the emilia study was flawed , and that " if I had t dm-1, I would not give it to my pt.s ". now this dr. vogel says t dm-1 is a " beautifully designed antibody drug conjugate ' ... yes it is , and that was clear to those lucky few to get a shot at it back in 2009 - 2013. Now my wife and I work for compassionate use / drug approval reform to give more stage iv.'s a chance