Genentech’s T-DM1 Phase III study on HER2-positive mBC meets primary endpoint

[annmask]

The problem of crossing bbb continues to be problematic, but Kadcyla is a wonderful new life extender, and QOA improver for us. We are all very grateful to have this option, and angry that it took so long to get here. The cost of these drugs is significantly increased by lengthly trial processes that result in many women dying while waiting for a chance to give a promising, well vetted new drug a try. While Tykerb crosses the bbb, many if not most suffer awful GI problems, and the activity in the brain is very weak- about 19%, explaining why it has been so disappointing as a brain treatment. Clearly we need new. more effective and less toxic small molecule drugs to fight HER2 disease, and many companies are working on this. Kadcyla is by fart the best yet for mets in the body for high expressing HER2+ MBC. May even be curative if given earlier in the disease process, that will be several year down the road as thing are currently going.

[gdpawel]

The future of anti-HER2 therapy lies in "combination" therapy more than from just relying on compounds such as Kadcyla, or Herceptin, or Tykerb or Perjeta. It is the good outcome of the patient not the therapy applied that constitute successful application of medicine. We can still hope for a good outcome if you use all the available drugs at our disposal that best meet the needs of the patient.

And relying on a companion diagnostic to identify cancer patients with HER2-positive metastatic cancer who "may" be eligible just for Kadcyla treatment is ambiguous. It examines "dead" tissue that is preserved in paraffin or formalin. which ruins sequencing capabilities, denatures everything and ruins the sample.

How is that going to be predictive to the behavior of your "living" cells in spontaneously formed colonies in the body? No gene-based test can discriminate differing levels of anti-tumor activity occurring among different targeted therapy drugs. Nor can it identify situations in which it is advantageous to combine a targeted drug with other types of cancer drugs.