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Old 12-07-2006, 05:35 PM   #1
Lani
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1 amazing case:metastatic her2 brst cn responding completely to herceptin monotherapy

It DOES HAPPEN ONCE IN A BLUE MOON:
Perhaps it reflects the synergy of herceptin and radiation therapy, perhaps not

: Breast Cancer. 2006;13(4):374-7.


A Case of Metastatic Breast Cancer with HER2 Gene Amplification that Responded Completely to Single Agent Trastuzumab.

Tsutani Y,
Ohsumi S,
Aogi K,
Taira N,
Kataoka M,
Hamamoto Y,
Nishimura R,
Takashima S.
Departments of Surgery, National Hospital Organization Shikoku Cancer Center.
An 80-year-old woman visited our hospital with a massive ulcerated tumor in the upper lateral quadrant of the right breast. Her performance status was 2. Histopathologically, a mass consisting of a huge primary tumor and metastatic axillary lymph nodes was seen and invasive ductal carcinoma was diagnosed. Both estrogen and progesterone receptors were negative. Herceptest(R) (DakoCytomation, Glostrup, Denmark) showed 2 + staining and HER2 amplification was detected by fluorescent in situ hybridization. CT revealed multiple lung metastases. Her old age and performance status of 2 made aggressive chemotherapy difficult. After receiving 5'-DFUR 600 mg/day as the first line treatment for two months, the tumors progressed. As second-line treatment, single agent therapy with a loading dose, a trastuzumab 4 mg/kg followed by 2 mg/kg weekly was recommended. The patient also received 60 Gy radiotherapy. Six months after the second line treatment, the breast tumor disappeared and only a scar remained on the chest wall and axilla. CT showed no lung tumors. During the trastuzumab treatment, no adverse effect was observed. Her performance status improved to zero, and she is alive and free from the disease 24 months after the disappearance of the tumor.
PMID: 17146166 [PubMed - in process]
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Old 12-07-2006, 10:03 PM   #2
tousled1
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Could it be the combination of the radiation and Herceptin? I've heard that getting Herceptin while undergoing radiaiton gives you an edge.
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Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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Old 12-07-2006, 11:55 PM   #3
Tom
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Kate,

Mom's oncologist agreed to let her begin receiving Herceptin at the same time she was undergoing radiotherapy after her lymph node dissection, rather than wait as he had originally proposed. I truly believe that this helped her greatly, as studies have shown that Herceptin can be a radiosensitizer.

Tom
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Old 12-08-2006, 02:43 AM   #4
tousled1
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Tom,

I had Herceptin the same time as radiation so hopefully I've gotten the same benefit from the combo that your mother did. Glad to hear that your mother continues to do so well. She's very fortunate to have such a loving son.
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Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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Old 12-08-2006, 07:35 AM   #5
Hopeful
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Wow! What a positive post!

If only we could figure out what made the drug work so well in this patient! I also had radiation with Herceptin. Reading this article will make me feel very good for the rest of the day. Thanks!

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