New to board - ? herceptin 3 yrs after tx

[Brea]

I am new to this board and have a question about herceptin. I was stage II, ER/PR -, HER2 + in 2003. I wasn't given herceptin after 6 rounds CEF because my Oncologist said it was only for patients with mets. I now have a few friends that are 2 and 3 years out of treatment and they have started herceptin. Does anyone have any info if it would still be effective that long after tx?

Thank you for your help.

[Lolly]

Just bumping this up so some who are more knowledgeable about this will give some input...

[Becky]

Theoretically, most oncologists don't like to give Herceptin 2 years out from chemotherapy. The rationale is that you are well over 2 yrs post surgery (when the clock starts ticking (and your true survivor date)). This is because the largest "blip" in recurrances occurs 2 yrs post diagnosis (ie: surgery) and the benefit may not outweigh the cardio risks. Also, there is no data in benefit of receiving Herceptin 1 year post the last chemotherapy (although there are oncs that will give adjuvant Herceptin post 2 yrs from the last chemotherapy).


The risk of recurrance for ER/PR negative Her2 disease really goes down after 2 yrs and even more so after 3 yrs hence the reluctance to give Herceptin so far out.

I hope this helps somewhat and gives you more reassurance.

Kindest regards

Becky

[Barbara]

Brea:

When I studied re-occurrence data, the article that was most often cited was a study of women who had NOT received any chemo (Saphner, et. al.) and in that study year two was the peak year for re-occurrences. But then I stumbled on a Canadian study of some 5000 node positve women who HAD chemo and in that study year three and four were the years of highest re-occurrence with a dramatic drop off after year four. It appears that chemo tends to push out the time frame for peak re-occurrence. Based on that data, if you had chemo it may be worth while to consider Herceptin if you have not reached the end of the fourth year post surgery.


Barb

[Ceesun]

Barbara makes a very good point on this. I was 20 months out of treatment when I started herceptin. My onc. did say that studies did not yet show if it would be beneficial but I wanted it and he agreed. Unfortunately after 9 months I did develop a lung met. He said that this did not mean the herceptin was not working-although disappointed it sure makes me glad I went for the herceptin. I continue on herceptin with other drugs added. He says I am now in partial remission after 2 cycles. Ceesun

[Brea]

Thank you all for your replies to my question. I am switching to a new Oncologist and hope she will be willing to let me start Herceptin. I recently moved and have had a difficult time finding the right Oncologist, I am also undergoing reconstruciton again as I developed a really bad infection in my implant and had to have it removed (LD and implant this time).

Again, thanks for the info.

Stacy

[vickie h]

Hi Brea, I have been on Herceptin for 2 years, 9 months and still going. I switched to a new Onc because my old one wanted to take me off the Herceptin and put me on Abraxane/ Avastin instead. I researched and found a breast cancer expert in Santa Monica, Ca, and switched to her immediately. I am now On Navelbine and Herceptin and yeasterday went for my first CAT scan /Pet scan since switching in August.. For the first time in almost 3 years, it is the CAt scan to come back completely clean. I am awaiting the PET results. Also my heart has shown very minimal, if any, dmage from the Herceptin. I have a friend who has been on it for 5 years and doing very good. I think it's great that you are seeing someone new. Don't give up, and accept what you may feel in your heart is the right treatment for you. All the research and opinions from well meaning friends are great, but it comes down to you saving your own life and I would run with that. It is what I have done, listened to my body and chosen the path that is right for me. Best of wishes and prayers to you, Vickie H

[Lani]

the Canadian series of 5000 women who had chemo--was that for breast cancer of all varieties vs her2+ breast cancer only ?

Thanks,
Lani