at ASCO meeting, poster presenter on measuring tumor markers in the CSF

[Lani]

(cerebral spinal fluid) in those with leptomeningeal metastasis

She had not looked at it in her2+ patients-- I suggested since there are now more patients receiving intrathecal herceptin, perhaps they should look at that as one way to monitor if it is working and see if efficacy and CSF biomarker are correlated.

Courtney--are they taking CSF samples and testing it for tumor cells or tumor markers to see how they are changing?

You are a pioneer and let's hope others can benefit from your experience

[CourtneyL]

Thanks for the post, Lani.

I've had my CSF tested for the presence of cancer cells twice now. Both times have tested negative. However, because two of my most recent brain mets appear outside the brain tissue itself, we are doing the intrathecal Herceptin as a way to reach these tumors. We do monitor my tumor markers about once a month (CA 15-3). But interestingly, they don't seem to correlate with my brain mets. They are extremely accurate at indicating what is going on with my disease below the neck. Every time they are on the rise, I have had progression and vice versa, when they go down, the tumors regress. However, when I was first diagnosed with brain mets in December 2008, my tumor markers were the lowest they'd ever been. So at least for me, they don't tell the whole picture.

I do indeed hope that others may benefit from my experience. I've just had my third intrathecal treatment and things are going well. We'll scan my brain again soon and I hope to see more shrinkage. I will, of course, keep all of you updated.

[Lani]

Courtney what these French researchers were doing was measuring Ca 15-3 in the CSF fluid itself. They hadn't looked at which of the patients were her2+ or not. Don't know how Ca 15-3 in CSF correlates with that in blood.

Thanks for your reply.

[CourtneyL]

Interesting. I'll ask my onc about this at my next appointment. However I would have no way of knowing what my baseline would be since I've had brain mets for years. If its elevated that won't really tell us much but perhaps we can look for trends down the road.

[Jackie07]

The CSF circulates around the skull and lubricates the spinal cord. I would think the odds to find tumor cells in CSF is slim at an early stage. The brain is unique because of the 'blood-brain barrier' mechanism.

But this is how science progresses - looking for clues at the 'improbable' place.