Clinical Trial Participation Tied to Improved Breast Cancer Outcomes

['lizbeth]

Yes Jackie - I couldn't agree more, cancer patients are entitled to make decisions based on factual data.

I question why surgeons are making a power grab to get an alert system.

The information in the study is from 1995 through 2008, over 5 years old - which is prior to almost all targeted therapies for the stage I, IIa & IIb.

I appreciate seeing what the industry is up to, but I feel this study wasted valuable dollars that could be used for something more valuable - like identifying the 6 of 10 women who are currently suffering through chemo, believing it is "saving" their life - when they are actually receiving no benefit from the treatment.

I downloaded information Lani posted - that I hope to find progress in identifying more of these patients. I'm off to eagerly devour the news!

I have much higher expectations for advances in the 21st century, a century in which cancer patients should not have to suffer through radiation, chemotherapy and surgery as standard of care.

[Jackie07]

The article was accessed in March, 2011. [Elsevier Global Medical News. 2011 Mar 15, P Wendling] There is usually a gap between data collection and the research publication date. Not sure if the investigators included those 2 years (between 2008 and 2010) in the 'survival' calculation.

The speed of telecommunication we have right now does make the 2, 3 years gap look 'huge'. But it's an retrospective study and the focus was to compare the outcome ...

I am not sure about your 'surgeons are making a power grab to get an alert system' statement. I've had five major surgeries so far and all my surgeons are extremely hard-working professionals who are dedicated to their work and their patients (the neurosurgeon operated 23 hours straight - drinking coffee and juice to sustain his energy; the breast surgeon squeezed my surgery into her busy schedule after a radiation oncologist friend talked [as a 2nd opinion doctor] to her on my behalf; the gynecological surgeon did the hyst/oo as soon as the proper instrument was received; the young doctor in the GKRS Center was cheerful and courteous ...) Perhaps I am a little biased as I love all my doctors... [My late Mother-in-law had told me back in 1990: "It's all right ... We all fall in love with our doctors." ]

[Jackie07]

Happened to see an abstract about the treatment of Her2-positive breast cancer [Notice the statement in the middle of the paragraph: "HER2-positive breast cancer in the setting of HER2-targeted therapy is no longer associated with poor prognosis" (Not sure if it's been posted before) Herceptin is a monoclonal 'antibody',and KADCYLA® (ado-trastuzumab emtansine = T-DM1) http://www.kadcyla.com/ is the new ‘antibody chemotherapy conjugate’]:

Breast. 2013 Dec 18. pii: S0960-9776(13)00300-7. doi: 10.1016/j.breast.2013.11.011. [Epub ahead of print]
Treatment of HER2-positive breast cancer.
Figueroa-Magalhães MC1, Jelovac D1, Connolly RM1, Wolff AC2.
Author information
Abstract
The human epidermal growth factor receptor 2 gene (HER2) is overexpressed and/or amplified in ∼15% of breast cancer patients and was identified a quarter century ago as a marker of poor prognosis. By 1998, antibody therapy targeting the HER2 pathway was shown to demonstrably improve progression-free and overall survival in metastatic disease, and in 2005 evidence of improvement in disease-free and overall survival from the first generation of trastuzumab adjuvant trials became available. However, not all patients with HER2 overexpression benefit from trastuzumab. Second-generation studies in metastatic disease led to the approval of several new HER2-targeted therapies using small molecule tyrosine kinase inhibitors such as lapatinib, new HER2/HER3 antibodies such as pertuzumab, and the new antibody chemotherapy conjugate ado-trastuzumab emtansine. These successes supported the launch of second-generation adjuvant trials testing single and dual HER2-targeted agents, administered concomitantly or sequentially with chemotherapy that will soon complete accrual. HER2-positive breast cancer in the setting of HER2-targeted therapy is no longer associated with poor prognosis, and recent guidance by the US Food and Drug Administration suggests that pathologic response to HER2-targeted therapy given preoperatively may allow an earlier assessment of their clinical benefit in the adjuvant setting. An adjuvant trial of trastuzumab in patient whose tumors express normal levels of HER2 and trials of single/dual HER2-targeting without chemotherapy are also ongoing. In this article, we review the current data on the therapeutic management of HER2-positive breast cancer.