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Great Article Lolly,
The stats....I don't know if we will ever get a total statisically sound study; the reason being that the patient would have to take herceptin forever and there are too many doctors still screwing around with dropping it, picking it up again, etc. As well, at this point in time, herceptin hasn't been out long enough to get any results of statistical significance. I'm sure that there are many anecdotal reports addressing this issue; in fact I think Jeff may have access to one or two??? The other confounding factor is the ability of HER2 status to change during mets. I think an example of this may be right in this study:
"The weekly combination of traztuzamab and P has recently been studied by Fornier et al (62) who reported a 71% response in HER2-positive patients (20/28), while only 37.5% of the HER2-negative patients responded. Several adjuvant trials currently underway should help to further define the role of traztuzamab in the treatment of early breast cancer."
Why would HER2 (-) patients respond at all? One plausible answer could be as follows:
The HER2 status was obtained from the primary tumour The 37.5% of HER2 (-) patients who did respond to herceptin did so because the distant mets changed to HER2 (+).
Getting back to the original comparison, how can we compare treatment results based upon HER2 status when HER2 is a moving target? In otherword, we could have 37.5% HER2+++ patients in the HER2 (-) arm of the studyand never know it (without an autopsy).
........................that's all................
Al
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