['lizbeth]

AussieGirl,

It has been very quiet eh? I've been chewing on this.

Recently there was all the press about not treating DCIS as a "cancer" and many women are not pursuing surgery for treatment. I find this interesting and contradictory to the neoadjuvant pCR with DCIS and the associated prognosis.

I did note from Neosphere, that the neoadjuvant pCR rate was about 40%, and from Tryphaena - adding anthracyclines increases it to the mid to upper 50s. Skipping the anthracyclines,and offering Taxotere, Perjeta Herceptin with Carboplatin increased pCR to 63.6%.

StephN brought up the TOPOII connection to anthracyclines. I would be interested in seeing a study that compared an arm of genetic profiling to functional profiling before neoadjuvant treatment. It is time for randomized studies to go the way of the dinosaur. I think functional profiling for CLL was a prudent FDA approval. And it time to start separating who benefits from neoadjuvant from the patients who are better served by surgery first.

So from my observation - Perjeta is effective, but adding the platinum salt increased pCR by 24%.

The question is: How does DCIS look under the microscope with Carboplatin?

Also, when will Perjeta be approved for early breast cancer in Australia? Do you follow NCCN guidelines or is there a set of Australian guidelines?

Thanks!