[hutchibk]

Thanks ya'll - I can't believe I just saw this... the version of the article that Flori posted had to be tweaked a little for accuracy, so here is the best and most current. I heard the word 'cure' regarding HER2 twice from prominent doctors during SABCS. And they seem to think it could be in the foreseeable future (what that would be, I don't know.... I am hopefully guessing 10 years give or take a couple) based on the rapid pace of unlocking the HER 1,2,3,4 network and the associated activations, reactions and aggravations by other pesky players such as Pten and tyrosine kinase...

BRENDA HUTCHISON
Finding Miracles
By Kathy LaTour
For the past two months, Brenda Hutchison has been telling friends and family about her continued success in battling the brain metastases that occurred after her initial breast cancer diagnosis in fall 2003 at age 44.

In the past 20 years, doctors have been able to determine if a woman's tumor is estrogen receptor positive. Soon afterward, the progesterone receptor marker was added. Then in the early '90s, researchers found that 25 percent of breast cancer patients have tumors that have human epidermal growth factor receptor status — commonly known as HER2. Each marker gives women more information about their tumors — and more information about which treatment will or won't work.

Hutchison's tumor was positive for all three markers. And as someone who wanted to take control of her own treatment, Hutchison got busy as soon as she was diagnosed to find her best options. She discovered that Herceptin (trastuzumab), a drug for HER2-positive tumors, was in phase III trials at the time and she applied to participate in one of the studies.

"The only reason they turned me down was that they could not get a clear picture of my liver," Hutchison says.

She proceeded with standard protocol chemotherapy and watched her tumor markers closely at every three-month checkup. Eighteen months after her diagnosis they started to climb.

During this time she went in to have scar tissue removed from her breast reconstruction implant. She got a call two days later that they found a tumor the size of a grain of rice. It was malignant — and ER negative. They also found a lymph node in her underarm that contained cancer cells, as well as positive nodes in her chest and suspicious spots on her lungs. The cancer was back.

By then, Herceptin had been approved, so her doctors gave her Herceptin with Taxol and carboplatin. By the next scan, it was clear the combo had worked. Her scans were clear, showing no cancer.

Early 2006

Hutchison's next scan six months later showed the nodes in her chest were positive again and a new bone metastasis on her neck. She went back on the Taxol/Herceptin cocktail and her tumor markers dropped.

Six months later her scans showed a new problem — three brain metastases and multiple other spots. While disappointing, it did not come as a surprise to either Hutchison or her doctors because at least 25 percent of women with HER2-positive metastatic breast cancer develop brain metastases. And treating brain metastases in the past has meant surgery or radiation because of the inability of most drugs to cross the blood-brain barrier.

When her oncologist said the standard of care was full-brain radiation, Hutchison began preparing, but a combination of Tykerb (lapatinib), a targeted agent that inhibits HER2 and HER1, and the chemotherapy agent Xeloda (capecitabine) was now available and clinical trials showed success in Tykerb's ability to cross the blood-brain barrier. Indeed, Tykerb had only been approved weeks before Hutchison needed it.

Hutchison discussed all the possibilities with her doctor and prepared for radiation, but on the morning of her first treatment, she called and canceled.

"I just had this feeling in my gut that I wanted to try the pharma approach first. I promised them we would scan in a month, and if there was activity we would do radiation," she says. "My doctors were amazingly wonderful. They knew I wanted to decide and they let me."

Amazing Results

At a scan 10 weeks later, the spots on her brain were gone and there was a 30 to 40 percent decrease in the other tumors. Another five weeks and her doctor did a full-body PET (positron emission tomography) scan that showed nothing "lighting up." He followed it with an MRI (magnetic resonance imaging) of the head — nothing but scar tissue.

Hutchison had no evidence of disease and her tumor markers had declined.

Hutchison talked with doctors and other advocates at SABCS, including Christine Druther and her husband, Joe, founders of HER2 Support, who were also enthusiastic about the reported results of Tykerb and Xeloda in brain metastases. Druther, who was diagnosed in 1990 with HER2-positive breast cancer, is in remission except for brain metastases, which has been continually treated over the years.

The Druthers and Hutchison, who has been involved in the HER2 Support organization, were looking forward to a presentation on Saturday afternoon by a researcher exploring other ways to use HER2 information.

"He talked about HER3 and HER4 and other receptors," Hutchison says. "While the science can be hard to understand, at the end he said he thought that one day we might be talking 'cure.' "

Hutchison says she wasn't sure she heard him correctly so she went up to him at the end of the talk to confirm what she heard.

"He said that yes, he thought it was possible," Hutchison says. "I said, 'Can I hug you?' "