ASCO herceptin trial updates for primary BC

Ladies, the hormone positive people do better in general due to tamoxifen/AI reducing their risk of recurrence by 40%. With chemo reducing 40%, the hormone therapy another 40%, the 15% added benefit of hercepting brings up the total benefit of tamoxifen+herceptin to about 55% -- essentially the same as the hormone negative ladies.
So, take a deep breath and relax!

[Lani]

I think you have oversimplfied the matter because the true statistics have not been gathered/published. The decrease in recurrence for AIs/other antihormonals are for ALL BC patients. As we all know, if you take statistics for ALL BC patients they just don't hold for her2+ patients. Her2 has not been tested for that long, in that many patients and with enough exactitude to generate the kind of statistics needed it seems.

I have asked Charles Perou, who is one of the world experts on the molecular subtyping of breast cancer (look his articles up on PubMed) about
where her2+ER+ tumors fit into all this

He admits they still really don't know where the "her2+ER+s" should be classified, with most of them falling within the luminal B group (which is a hodgepodge of other tumors with quite diverse gene expression profiles)rather than in the "her2 group" (where the her2+ER- tumors lie)

Most have VERY different genes up- and down- regulated than most her2+ER- TUMORS and there is a great deal of diversity even within the her2+ er+ group.

The old statistics from Adjuvant online have not yet been adjusted to take into account our knowledge of the molecular subtyping. I will be hearing a lecture from the man who "invented" Adjuvant online within the next month in which he discusses just that.

Who would pay for all breast cancer tumors to have a gene expression profile( best done on fresh or freshfrozen tumor specimens) in order to subcategorize them to discover the natural history of each, recurrence rate of each, best treatment for each?

If Edwards were President or VP, I am sure the money would be found.

Were that to occur ie, with such a precedent, I am certain the fight against cancers OF ALL TYPES
would be greatly accelerated.

[Hopeful]

Lani,

Wow, you got to speak with Dr. Perou - how cool! I read as many of his papers as I could find on line right after I was dx last year. Thanks very much for clarifying that the Her2+ ER+'s are classified as Luminal B. I have tried searching for hard stats on how AI's affect specifically Her2+ ER+'s, but, other than references that they are an improvement over Tamoxifen, I have found nothing more specific.

Hopeful

[Christine MH-UK]

Hi Lani,

What you are describing in terms of looking at large numbers of breast cancer markers, treatments used, and recurrence rates sounds like what the 'Help Defeat Cancer' project on the World Community Grid has been trying to do. As I recall they were analyzing microarrays of hundreds of thousands of samples and were hoping that findings could be used to match treatments to patients. Researchers at a medical school in New Jersey had developed the project and prepared all the samples. The computers just finished crunching the data from the project a short time ago, so there are no findings yet, but this is an active area of research.