Hormone Therapy

[Kristin]

So my mom is Her 2+, ER+/PR-, post metpausal and she is on Herceptin currently. She had two treatments of Abraxane back in July, but then stopped due to surgery she needed to have. She decided not to go back on chemo cause her markers are now in the normal range, 201 dropped to 34. Either those two Abraxane treatments really worked great or it's the Herceptin. Anyway, I asked the onc to put her on hormone therapy and she keeps saying no b/c she is PR- and it only works for people ER+PR+. I brought her the news on Arimedex showing good results for ER+PR- and she still won't put her on it. She is all about chemo only!!! My mom is tried of chemo and needs a well deserved break, she is doing the Herceptin but I wanted to try hormones also to keep her tumors undercontrol. I also asked about Avastin and she said it is not approved yet for bc in the states, is this true???? Anyone in a similar situation regarding hormone therapy.
Thanks, Kristin

[Lolly]

Hi Kristen; I think it's true that Avastin isn't approved for BC YET, but there are trials ongoing. It is approved for colon cancer but an oncologist CAN use a drug, that's approved for a particular use, for other types of cancer if they want to go "off protocol". A lady at my treatment center is getting it for BC mets along with another chemo. So it depends on the doctor.
I'm ER/PR- so I'm not up to speed on the hormone options, but I know someone will post who knows more about it.
Keep your chin up, you're doing a great job advocating for your mom!

<3,
Lolly

[Becky]

Kristin


I am ER+ but less than 5% + for PR (and some oncos will say that is negative). I am on Arimidex (and Herceptin).

Secondly, I have a chemo friend who is Her 2+ and ER +, diagnosed 5 yrs ago Stage 4 inflammatory and she is on Avastin, Herceptin,Arimidex, Taxotere and Zometa. She is doing well. She got the Avastin originally at the Mayo clinic about 2 years ago. Her onco here (another Dr. in the practice I go to) would not give her Avastin so she would go to Houston to get it every week. After the phase I clinicals showed some positive results, the onco here gave her the Avastin (so check around as some oncos will give it if there are at least some results that are good and you are stage 4).

Best regards

Becky

[al from Canada]

Dear Kristin and Lolly,

Here is the conclusion to a fairly lengthy study suggesting that in ER+, HER2+ disease, suggesting that herceptin + AI (combination) therapy may be provide additional clinical benefit.
Take care,
Al




"Conclusions

In conclusion, the evidence that HER2 overexpression is correlated with poor clinical outcome, the existence of cross-talk between the HER2 and ER signalling pathways in breast cancer, and the lack of benefit achieved with hormonal therapy in patients with ER-positive/HER2-positive disease, and hence the fact that these patients are receiving sub-optimal treatment, suggest that combining treatments that target these different pathways may provide additional clinical benefits for patients with breast cancer. Trastuzumab has produced significant survival improvements in combination with chemotherapy in the first-line treatment of HER2-positive metastatic breast cancer and has also shown activity as a single agent as first- or second-line therapy. Tamoxifen has been shown to produce clear benefits in terms of survival and prevention of recurrence for both premenopausal and postmenopausal women with ER-positive breast cancer. Recent studies of aromatase inhibitors have demonstrated superior objective responses in comparison with tamoxifen. Taken together the evidence suggests that targeted non-chemotherapeutic combinations of trastuzumab with hormonal therapy, which are currently being studied in large-scale clinical trials, represent the future of cancer therapy, allowing the individualisation of treatment based on tumour characteristics."

Hi, I too am not hormone responsive, post menopausal now, however I was given Aromasin for the last 2 years and at one stage it shrunk and destroyed enlarged nodes in my neck. I am off it at the moment because it blocked all eostrogen entirely, and I need to have my BC cells grow so the chemo can find them to destroy them, I know this because when I had my last Pap Smear it came back as irregular because there was no eostrogen and I then had to use an eostrogen cream Ovastin for one week before the next and it then came back normal. My own GP is able to give me a script for Aromasin and I am in Australia and we are 5 years behind the States. The blocker didn't keep the BC entirely away but I do believe it with the Herceptin slowed it down and degraded it to a less agressive BC this time. Hope this helps.

Love & Hugs Lyn