HER2 Support Group Forums - View Single Post - CEP17 seems to be key to anthracycline susceptibility

Debbie L. · 03-27-2010, 08:01 PM

I do so wish that we had an answer to this. But the waters remain muddy. Same conference (EBBC7):

http://cmwebcast.covr.be/presentatio...6/default.aspx

I need to watch this again, but what I heard was that they saw topo2a association with anthracycline response in ER negative cancers, not just HER+ cancers. Which would seem to say that it's not CEP17, and not HER2+ either.

Denny Slamon has so far maintained that the marker for additional benefit of anthracycline is topo2a (overexpression, amplification, deletion?) AND that the relevant topo2a mutations are limited to HER2+ cancers.

So although this link that I've provided seems to implicate topo2a (rather than CEP17), it does not limit the topo2a mutations to HER2+ cancers.

Whatever is the marker for additional benefit of anthracyline, we are talking about an important subgroup of cancer, because they are high-risk cancers. If anthracyclines do offer an additional benefit to some subgroup within these subtypes (ER-, HER2+, topo2a mutated), the absolute value of the additional benefit is high, because the risk is high.

Like I said, frustrating. All of these discussants (Slamon, Bartlett, Jules Bordet institute/Piccart) are well-respected experts. How to know what's the truth?!

I used to think that this was nitpicking. But the more I pay attention, the more women I meet who are post-treatment. When these wonderful women die from side effects of TREATMENT rather than from their breast cancer (Madubois on this list from anthracycline se's, Carolina Hinestrosa of NBCC from radiation se's), it forces me to pay more attention to the issue of treatment implications.

03-27-2010, 08:01 PM	#2
Debbie L. Senior Member Join Date: Jul 2006 Posts: 463	Re: CEP17 seems to be key to anthracycline susceptibility I do so wish that we had an answer to this. But the waters remain muddy. Same conference (EBBC7): http://cmwebcast.covr.be/presentatio...6/default.aspx I need to watch this again, but what I heard was that they saw topo2a association with anthracycline response in ER negative cancers, not just HER+ cancers. Which would seem to say that it's not CEP17, and not HER2+ either. Denny Slamon has so far maintained that the marker for additional benefit of anthracycline is topo2a (overexpression, amplification, deletion?) AND that the relevant topo2a mutations are limited to HER2+ cancers. So although this link that I've provided seems to implicate topo2a (rather than CEP17), it does not limit the topo2a mutations to HER2+ cancers. Whatever is the marker for additional benefit of anthracyline, we are talking about an important subgroup of cancer, because they are high-risk cancers. If anthracyclines do offer an additional benefit to some subgroup within these subtypes (ER-, HER2+, topo2a mutated), the absolute value of the additional benefit is high, because the risk is high. Like I said, frustrating. All of these discussants (Slamon, Bartlett, Jules Bordet institute/Piccart) are well-respected experts. How to know what's the truth?! I used to think that this was nitpicking. But the more I pay attention, the more women I meet who are post-treatment. When these wonderful women die from side effects of TREATMENT rather than from their breast cancer (Madubois on this list from anthracycline se's, Carolina Hinestrosa of NBCC from radiation se's), it forces me to pay more attention to the issue of treatment implications. __________________ 3/01 ~ Age 49. Occult primary announced by large (6cm) axillary node, found by my husband. 4/01 ~ Bilateral mastectomies (LMRM, R elective simple) - 1.2cm IDC was found at pathology. 5 of 11 axillary nodes positive, largest = 6cm. Stage IIIA ERPR 5%/1% (re-done later at Baylor, both negative at zero). HER2neu positive by IHC and FISH (8.89). Lymphovascular invasion, grade 3, 8/9 modified SBR. TX: Control of arm of NSABP's B-31 adjuvant Herceptin trial (no Herceptin, inducing a severe case of Herceptin-envy): A/C x 4 and Taxol x 4 q3weeks, then rads. Raging infection of entire chest after small revision of mastectomy scar after completing tx (significance unknown). Arimidex for two years, stopped after second pathology opinion. 2017: Mild and manageable lymphedema and some cognitive issues.