[Lani]

Flori--I just got back from the AACR annual meeting. Apparently Avastin seems only to
slow down progression of disease, but not change overall survival in any way.

Perhaps your oncologist knows of other means of achieving antiangiogenesis without the same side effects ie, metronomic chemotherapy, NSAIDs etc

One word of caution (and unfortunately I could not split myself into six clones and attend all sessions that interested me): there are those who have observed a rebound of tumors after discontinuing avastin --originally described in mice, don't know how often in humans--felt to happen because although avastin kills the blood vessel lining cells of the blood vessels feeding the tumor, it does not destroy the framework of the scaffolding for the blood vessels, so once it is stopped the scaffolding is already there which means it take much less time, effort and energy to reconstitute a new vascular system to feed the tumor.(like leaving the foundation and bearing walls rather than destroying an entire house, it is much quicker,easier to rebuild the house)

Someone from Genentech talked about the phenomenon and whether it was
found in humans and what could be done about it. I knew I would be sorry if I didn't attend--that someone would expect me to be able to help with that knowledge, but knew most talks were taped and could be bought through a company for listening afterwards ($399 for the entire meeting, but I met someone perhaps willing to split costs). If I get the tape I will listen to the talk and update you.

With that in mind, it might theoretically be best to add something else antiangiogenic when stopping avastin, although I generally agree with Becky that it is generally a good principle to stop one thing at a time to see what is causing a problem.

I also met someone from the NIH who is interested in having her2+ patients
for a trial he is doing with a radionucleide (radioactive-labelled compound) which is targetted with herceptin which seeks out and identifies (and perhaps someday treats) residual her2+ residual disease.

There were loads of new drugs being found useful in her2+ disease, and very hopeful reports with panher blockers.

Hopefully the cavalry (of new drugs) is coming over the hill just in time to be available to help if you find your present combo is not all it can be.

Best of luck!