Soccermom/marcia: Thanks for starting this interesting conversation!
DLaxague/debbie:
1. Why would the amount of tumor burden at time of taking action in previously NED patients be irrelevant? Are there large and reliable studies that show that to be true?
2. Are you basically saying that because a drug like trastuzumab (plus perhaps additional drugs such as chemo or other) is so successful for so many previously NED in knocking mets to the NED again, that there is no reason to use markers for the smaller number of seemingly NED patients in whom it is unknown that trastuzumab (plus perhaps additional drugs such as chemo or other) is not working?
3. In trying to understand the concept that there is really no benefit to markers in those who are initially NED after treatment, I understand that means there are 3 groups of bc patients: those who have mets at diagnosis, those who stay NED indefinitely, and those who eventually develop mets. And I do understand that what you are saying is based on impartial study results, not on intuitive logic. But since we only know for sure who is in which group in regard to those who have mets right off the bat, why would the covert development of additional tumor burden in seemingly NED patients not be more likely to shorten life sooner? Are the studies really showing not so much that markers don't matter, but rather that treatment is so lousy for those in whom Herceptin (plus or minus other drugs) does not work, that knowing the cancer is back makes no difference?
FOB: Thanks for the question about PR- and PR+ and c-erb-2, as I too was confused by that... and sort of still am... I've not seen c-erb-2 used before to mean serum HER2 measurement.... but guess that is what they mean? Always c-erb-2 has meant only the tissue testing before... from what I've seen, anyway.
A.A.
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