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rhondalea · 12-28-2011, 08:22 AM

This might help, Raquel:

http://breast-cancer-research.com/content/10/4/R60

Abstract

Introduction

We performed a retrospective analysis of HER2-overexpressing metastatic breast cancer patients to describe clinical outcomes of those who, despite progression of the disease (PD), maintained trastuzumab for multiple chemotherapy lines. We also compared survival of these patients with that of those who halted trastuzumab at first PD.
Methods

We identified 101 patients treated between July 2000 and January 2007. Nineteen were still receiving the first-line trastuzumab-based treatment without evidence of PD and were not included in this analysis. Of the remaining 82 patients, 59 retained trastuzumab for one or more additional lines of chemotherapy after PD, according to our institution policy. Twenty-three patients who changed treating institution and stopped trastuzumab at first progression were used as a control group.
Results

For patients retaining trastuzumab, the median follow-up was 39.6 months. Clinical outcomes showed the typical degradation between first and second lines of therapy which we would expect by halting trastuzumab at first progression. Response rates were 35% and 16% and median times to progression were 7.25 and 5.25 months for the first and second lines of trastuzumab therapy, respectively. The median overall survival (OS) rates were 70 months for patients who retained trastuzumab and 56 months for patients who halted the drug (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.51 to 1.18; P = 0.52). If we consider OS from the start of trastuzumab therapy, the figures are 53.9 and 34.8 months, respectively (HR 0.78, 95% CI 0.58 to 1.32; P = 0.2).
Conclusion

A nonstatistically significant trend of improved survival for patients retaining trastuzumab is observed. This is in line with most retrospective analyses and recent randomized data. Retaining trastuzumab after progression is a reasonable option, but further randomized data are warranted to better define its role in comparison with other available options.

This is a very long pdf:

http://www.asco.org/ascov2/Home/Educ...0111000014.PDF

And this is directly to the point:

http://www.medscape.com/viewarticle/713808

There are more out there, but these were representative.

12-28-2011, 08:22 AM	#28
rhondalea Senior Member Join Date: Jun 2011 Location: Somerset, NJ Posts: 487	Re: Lung met question This might help, Raquel: http://breast-cancer-research.com/content/10/4/R60 Abstract Introduction We performed a retrospective analysis of HER2-overexpressing metastatic breast cancer patients to describe clinical outcomes of those who, despite progression of the disease (PD), maintained trastuzumab for multiple chemotherapy lines. We also compared survival of these patients with that of those who halted trastuzumab at first PD. Methods We identified 101 patients treated between July 2000 and January 2007. Nineteen were still receiving the first-line trastuzumab-based treatment without evidence of PD and were not included in this analysis. Of the remaining 82 patients, 59 retained trastuzumab for one or more additional lines of chemotherapy after PD, according to our institution policy. Twenty-three patients who changed treating institution and stopped trastuzumab at first progression were used as a control group. Results For patients retaining trastuzumab, the median follow-up was 39.6 months. Clinical outcomes showed the typical degradation between first and second lines of therapy which we would expect by halting trastuzumab at first progression. Response rates were 35% and 16% and median times to progression were 7.25 and 5.25 months for the first and second lines of trastuzumab therapy, respectively. The median overall survival (OS) rates were 70 months for patients who retained trastuzumab and 56 months for patients who halted the drug (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.51 to 1.18; P = 0.52). If we consider OS from the start of trastuzumab therapy, the figures are 53.9 and 34.8 months, respectively (HR 0.78, 95% CI 0.58 to 1.32; P = 0.2). Conclusion A nonstatistically significant trend of improved survival for patients retaining trastuzumab is observed. This is in line with most retrospective analyses and recent randomized data. Retaining trastuzumab after progression is a reasonable option, but further randomized data are warranted to better define its role in comparison with other available options. This is a very long pdf: http://www.asco.org/ascov2/Home/Educ...0111000014.PDF And this is directly to the point: http://www.medscape.com/viewarticle/713808 There are more out there, but these were representative. __________________ 2/6/09 Core needle biopsy: negative; Mammos through 2010: no change 3/30/11 Pea-sized lump in left breast at site of prior biopsy; mammo negative, sonogram not so much 4/14/11 Core needle biopsy: negative for cancer 5/18/11 Excisional biopsy 1.2 cm tumor, LVI, positive margin; ER+60%,PR+20%,HER2/CEP17 5 6/15/11 BMX: Left DCIS & LH; Right ADH; SNB: 2/3 nodes: 1.4 cm and 1 mm; ALND L1&2: 0/10; Stage IIa, Grade 3 7/14/11 CT/Bone scans NED; MUGA 66% 7/19/11 Biweekly dd AC w/Neulasta; done 8/30/11 9/13/11 Transfusion (Hemoglobin 8.6); MUGA 64% 9/20/11 Start Taxol + Herceptin; Taxol done 12/6/2011; continue Herceptin until 9/4/2012 12/27/11 Radiation - 6 weeks; 2/27/2012 - DONE! Yayyyy! 2/29/12 Start Tamoxifen 20 mg/day; continue until 2/28/17 5/16/12 Start five-years Metformin trial 6/19/12 MUGA 61% 8/21/12 Brain MRI NED (head still hurts, brain still fogged) 9/4/12 Herceptin done! 9/6/12 Port out! 7/11/13 Aricept 5mg for cognitive impairment; increased to 10mg as of 8/23/13; back to 5mg 12/2013 5/2014 Add Namenda 7mg 9/2014 Stop Aricept and Namenda; Neuropsychological evaluation 10/24/14 Start cognitive rehabilitation therapy