Christmas is coming early this year--review article on brain mets in her2+ patients--

[Lani]

FOR HUTCHBK, BELIEVE 51 AND OTHER FACING DECISIONS ON HOW TO TREAT BRAIN METS--it reviews more information including intrathecal herceptin, than I had previously seen

and its free access!

1: Ann Oncol. 2009 Aug 28. [Epub ahead of print]

Trastuzumab treatment in patients with breast cancer and metastatic CNS disease.

Pienkowski T, Zielinski CC.
Department of Breast Cancer and Reconstructive Surgery, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland.
BACKGROUND: Patients with metastatic central nervous system (mCNS) disease progression from breast cancer have a poor prognosis and often develop associated neurological complications. Human epidermal growth factor receptor 2 (HER2)-positivity status increases the risk of developing mCNS disease. Trastuzumab is an mAb that targets HER2 and is known to extend survival across all stages of HER2-positive breast cancer. Design: This review considers evidence from preclinical and clinical studies examining the value of continuing trastuzumab treatment in patients who develop mCNS disease. A wealth of data from clinical studies showed that trastuzumab prolonged survival in patients with mCNS disease, compared with no trastuzumab treatment, by effectively controlling their non-CNS disease. Trastuzumab has also been shown to penetrate an impaired blood-brain barrier to a limited degree, such as during radiotherapy, and intrathecal delivery of trastuzumab to the central nervous system (CNS) has shown promise. Research efforts are focussing on improving the delivery of trastuzumab to the CNS. CONCLUSION: Evidence indicates that patients with mCNS disease from HER2-positive breast cancer should continue to receive trastuzumab to control HER2-positive metastases outside the CNS and receive established therapies to control the mCNS disease.
PMID: 19717536 [PubMed - as supplied by publisher]

hope my link works!: http://annonc.oxfordjournals/cgi/reprint/mdp353v1.pdf

if unable to find a link that works for free, perhaps email the author at


review

Trastuzumab treatment in patients with breast cancer and metastatic CNS disease

T. Piekowski1,* and C. C. Zielinski2
1 Department of Breast Cancer and Reconstructive Surgery, Maria Skodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
2 Clinical Division of Oncology, Department of Medicine I, Medical University Vienna and Central European Cooperative Oncology Group, Vienna, Austria

* Correspondence to: Prof. T. Piekowski, Department of Breast Cancer and Reconstructive Surgery, Maria Skodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland. Tel: +48-22-644-0024; Fax: +48-22-644-0024; E-mail: tpienkowski@coi.waw.pl

[CourtneyL]

Thank you darling, Lani! This is good to know. My onc and I were discussing whether or not to go off vitamin H but now I am leaning towards staying on it.

[Darlene Denise]

Courtney: I hope you will stay. I'm on it again. My onc took me off based on dosing recommendations of Dana Farber but since I'm such a wussy, I haven't been able to do the full dose of Tykerb or Xeloda. Seven weeks ago I begged for it and Chemosabe gave in. I have read several medical papers suggesting that there is a survival advantage for us CNS gals.

If you are tolerating it well, why leave it? Please let us know what you decide.

May the force be with us...Darlene

[Lani]

There are numerous papers on the benefit of staying on herceptin after CNS mets are diagnosed.

Glad the article was useful--by the way, were you able to access the whole article? l was unsure of my link

[CourtneyL]

Yes, I am planning on staying on Vitamin H as long as it continues to hold things below the neck at bay. I just worry about the cumulative effects of being on so many drugs and the long-term effects on the heart. But that really shouldn't be my main concern at this point. I just want to survive and beat down the beast however I can. Thanks Denise and Lani.