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Old 02-23-2011, 07:22 AM   #1
1rarebird
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ER, PR & Her2 status may predict treatment

This Korean clinical study found for ER+ breast cancer, Pr negative status may predict poorer outcomes with Tamoxifen treatment and Her2 positive status may be best treated with long-term Her2-target therapy. I believe similar findings have been developed by other studies.--bird






J Cancer Res Clin Oncol. 2011 Feb 16. [Epub ahead of print]
Clinical significance of progesterone receptor and HER2 status in estrogen receptor-positive, operable breast cancer with adjuvant tamoxifen.

Moon YW, Park S, Sohn JH, Kang DR, Koo JS, Park HS, Chung HC, Park BW.
Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Abstract

PURPOSE: To evaluate prognostic factors in estrogen receptor (ER)-positive, operable breast cancer focusing on the progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2).
PATIENTS AND METHODS: A total of 819 patients with ER-positive, operable breast cancer were enrolled. All patients received upfront adjuvant tamoxifen, as stipulated by eligibility criteria. Prognostic values of the PR status and HER2 status were evaluated using Cox regression.
RESULTS: Of all patients enrolled, 72% were PR positive and 20% were HER2 positive. PR and HER2 status were inversely correlated (P = 0.014). PR-negative tumors were associated with older age over 50 years (P < 0.001) and higher histologic grade (P = 0.024). HER2 overexpression correlated with older age over 50 years (P = 0.007), higher T stage (P = 0.010), and higher histologic grade (P = 0.047). For recurrence, PR negativity was a poor prognostic factor before 5 years postsurgery (hazard ratio = 1.57; P = 0.049) and HER2 overexpression was a consistent poor prognostic factor over all time periods (hazard ratio = 1.93; P = 0.001) in the multivariate model adjusted by age, T/N stage, and histologic grade.
CONCLUSIONS: In ER-positive, operable breast cancer, PR negativity may provide additional information on poor prognosis or tamoxifen resistance during adjuvant tamoxifen therapy within 5 years postsurgery. HER2 overexpression was a poor prognostic factor consistently throughout time. This suggests that an alternative adjuvant strategy, possibly incorporating prolonged HER2-targeted therapy, needs to be evaluated for HER2-overexpressing tumors.

PMID: 21327800 [PubMed - as supplied by publisher]
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Male Breast Cancer, DX 5/15/09, IDC, STAGE 1, 1.7 cm, HER2+++, ER+(95%)/PR+(75%), Ki67 40%, grade 3, 0/5 nodes, TX: mastectomy, TCH finished 7/19/10, radiation 6 wks., Tamoxifen on going, bisphosphonate 24 mos.
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Old 02-23-2011, 04:06 PM   #2
Jackie07
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Re: ER, PR & Her2 status may predict treatment

"This suggests that an alternative adjuvant strategy, possibly incorporating prolonged HER2-targeted therapy, needs to be evaluated for HER2-overexpressing tumors."

I have a feeling that the subjects in this study did not get Herceptin/Tykerb at all. Of course they are going to conclude it's "a poor prognostic factor consistently throughout time."
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6 TCH Cellulitis - Lymphedema - compression sleeve & glove
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Old 02-23-2011, 04:42 PM   #3
Jackie07
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Re: ER, PR & Her2 status may predict treatment

Found another (interesting) abstract:

Clin Med Res. 2011 Jan 24. [Epub ahead of print]
Blood Type, Hormone Receptor Status, HER2/neu Status, and Survival in Breast Cancer: A Retrospective Study Exploring Relationships in a Phenotypically Well-Defined Cohort.

Klimant E, Glurich I, Mukesh B, Onitilo A.
* Cancer Treatment Centers of America, 1331 East Wyoming Avenue, Philadelphia, PA, USA; Email: Eiko.klimant@ctca-hope.com.
Abstract

Purpose Altered glycosylation has been associated with oncogenic potential. Relationships of blood types (where expression is due to glycosylation pattern) and HER2/neu (where expression arises due to altered glycosylation) and breast cancer-associated markers like estrogen receptor/progesterone receptor (ER/PR) were examined and related to outcomes in patients with breast cancer. Methods A population-based retrospective study of 426 surgical breast cancer patients examined relationships between 1) patient characteristics, 2) breast tumor characteristics, and 3) outcomes of women diagnosed at the same medical center over a 10-year period relative to specific molecules defined by glycosylation patterns (eg. blood group, HER2/neu,) and 4) ER/PR status. Results Following stratification by blood group subjects exhibited significant differences only in tumor size with persons with blood group A and B having greater numbers of tumors ≤ 2cm and those with blood AB and O having tumors >2cm. After adjusting for age, disease stage, and treatment with trastuzumab, tamoxifen, or aromatase inhibitors, no significant differences were observed in 5-year overall and disease-free survival based on blood type grouping. Blood group B was overrepresented among the breast cancer cohort compared to the reference population, while blood group AB was under-represented. Conclusion No significant differences were observed in overall and disease-free survival based on blood group. No correlation was noted between HER2/neu, ER or PR status, and blood group type. Among this cohort, HER2/neu positivity was less than 20% and correlated with a 5-year disease free survival rate ≥ 75% and overall survival of >80% across all blood groups.
__________________
Jackie07
http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016
7-23-2018 9 mm groundglass nodule within the right lower lobe with indolent behavior. Due to possible adenocarcinoma, Recommend annual surveilence.
7-10-2019 CT to check lung nodule.
1-10-2020 8mm stable nodule on R Lung, two 6mm new ones on L Lung, a possible lymph node involvement in inter fissule.
"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe
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