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Old 12-17-2007, 04:11 AM   #1
Lani
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patient centered her2+ breast cancer research--PLEASE VOLUNTEER to donate your tumor

Only a small core would be necessary. There is a possibility one project involves a small blood sample and all projects would involve your signing away to the researcher access to your medical history/records.

How about making history by accelerating the progress into research into her2+ breast cancer by light-years by giving promising researchers on the brink of gaining true insights into her2+ breast cancer much larger amounts of specimens to study than they could ever hope to (as they are limited to studying those samples generated at their own institution only or those generated by a clinical trial only). They have troubles even studying those at their own medical institution as not all continued to have their care at that insititution and also, even within those treated at their institution, they cannot access the medical records to see how those patients did with or without treatment, and which treatments, as medical privacy protection laws passed during the Clinton administration (HIPAA) prevent them from being able to access that information!

I am too tired to post the four names and what research they are engaged in at the moment (plus it is fun to raise expectations and anticipation!), but I will give you an enticing amount of information to figure out who one of them is, an let you know that I found one in London for those whose specimens lie in the UK or EU.

Here is what I have already posted about it:


I went among the poster presenters and speakers at SABCS with the unspoken mandate to search among them to find those who represent the best hope of fulfilling the wishes of those who participate and/or just lurch on this site who are willing to donate serum, part of their surgical specimen and the right to have others access their medical records (with privacy maintained, of course) for the greater good ie, to have these researchers utilize the information gathered to further the understanding of the causes of, behavior of, and best treatment for her2+ breast cancer.

I took the mandate I believed I had very seriously and sought out those who had published the best research and those whom I felt were presenting useful information, were associated with researchers worthy of reslpect and those who , in conversation regarding their posters (or in once case, another researchers' posters) demonstrated a passion to provide clinically useful progress in furthering understanding in an extraordinary way and/or providing in the near term something useful respect to help deciding between treatments or the treatments themselves for her2+ breast cancer.

I came up with four such persons. I will post this as its own thread and under the original thread by Alaska Angel in which I suggested this as a way to honor those we have lost as well as benefit all.

I explained to these researchers that I could not promise to deliver these samples, but that over the almost three years I have provided information to this site that I sensed there were a large number of those whom I would, rightly or wrongly, expect to be women (and men) of action and not just words. I hope you prove me right! I will be adding more over the next few days and weeks as to how we can turn this from a nice idea into a powerful
tool. All the researchers were extremely intrigued by the opportunity to have not just the large numbers of specimens this site could potentially make available but also the medical histories/records that go along with them. Here in the US that has been made exceedingly difficult by the medical privacy laws referred to as HiPAA that were passed under Clinton and have been a bane to medical researchers ever since.

My personal favorite among the researchers was the one responsible for that wonderful paper wherein her2+ breast cancer (actually a cell line which is her2+ER+ called BT474 when purposefully utilized to cause breast cancer in mice) could be CURED, yes CURED, by a combination of pertuzumab, herceptin and Iressa (when I asked one of the authors at the AACR breast cancer meeting in San Diego in October why it was felt that it was not necessary to add estrogen deprivation or tamoxifen to cure the disease in this one instance, his answer was that it was postulated that blocking the four her family members' pathways simultaneously was so effective SO QUICKLY that there was insufficient time for the tumor to mutate (or another minor clone to become dominant).

In view of the views of Max Wicha, presented at last week's SABCS that her2 is responsible for enriching the number of stem cells within any one tumor, supported by Jenny Chang's paper in which she showed via a neoadjuvant lapatinib trial that neoadjuvant lapatinib caused a decrease in the stem cell content of a her2+ tumor (in humans, not mice!--she has not yet done the same experiment with neoadjuvant herceptin) it looks like her2 neu is the leading beacon pointing the way to making progress in breast cancer in a way that may benefit research into ALL CANCERS.

I did not speak with Jenny Chang, but she is at the same institution as the "favorite paper author" I apoke of above and will be sharing this information (possible availability of numerous her2+ breast cancer tumor specimens with matched medical histories and possibility of serum samples) with her institution (Baylor) and her colleagues.

Once I get unpacked I will provide more information on those I felt were worthy of winning this lottery. There may have been others, but these
seemed to take the cake.

Now it is up to all of you (including those in the UK, Europe, etc, as I found one researcher from London) to put your pathology where your mouths are ( a variation of the English phrase "to put one's money where one's mouth is", which refers to actually acting on one's word, not just maklng promises).

One is part of the problem if one is not part of the solution.

I informed all researchers that I am participating incognito and wish to remain that way. If others, such as Cynthia (with her legal background), Rhonda H (with her no-nonsense proactive approach and generosity) or others wish to come forward and help with the logistics of all this, it would
help speed this from a nice idea toward fruition into a reality.

Comments?
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Old 12-17-2007, 10:41 AM   #2
SoCalGal
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Exclamation Lani - what do you mean by this?

Lani,
You write: "I am too tired to post the four names and what research they are engaged in at the moment (plus it is fun to raise expectations and anticipation!), but I will give you an enticing amount of information to figure out who one of them is, an let you know that I found one in London for those whose specimens lie in the UK or EU. "

What do you mean by this post -especially the comment in red? Many are too ill and too overwhelmed to go on a Where's Waldo expedition. It does take a great deal to coordinate the logistics of "giving" our tumors to the right places, along with releases and blood work BUT I'm sure we would all cooperate if we knew specifically what and how to do it. If you want to spear head something like it it's your choice. If you want to coordinate a team, or want support from us I'm sure you'll get it. Like you said, perhaps some of the woman here who are physically able to move this forward can band together and do so. We are people of action.

I know I'm in a chemo fog BUT, this wording is very troubling to me. -Flori





__________________
1996 cancer WTF?! 1.3 cm lumpectomy Er/Pr neg. Her2+ (20nodes NEGATIVE) did CMF + rads. NED.
2002 recurrence. Bilateral mastectomy w/TFL autologous recon. Then ACx2. Skin lymphatic rash. Taxotere w/Herceptin x4. Herceptin/Xeloda. Finally stops spreading.
2003 - Back to surgery, remove skin mets, and will have surgery one week later when pathology can confirm margins.
‘03 latisimus dorsi flap to remove skin mets. CLEAN MARGINS. Continue single agent Herceptin thru 4/04. NED.
‘04 '05 & 06 tiny recurrences - scar line. surgery to cut out. NED each time.
1/2006 Rads again, to scar line. NED.

3/07 Heartbreaking news - mets! lungs.sternum. Try Tykerb/Xeloda. Tykerb/Carbo/Gemzar. Switch Oncs.
12/07 Herceptin.Tykerb. Markers go stable.
2/8/08 gamma knife 13mm stupid brain met.
3/08 Herceptin/tykerb/avastin/zometa.
3/09 brain NED. Lungs STABLE.
4/09 attack sternum (10 daysPHOTONS.5 days ELECTRONS)
9/09 MARKERS normal!
3/10 PET/CT=manubrium intensely metabolically active but stable. NEDhead.
Wash out 5/10 for tdm1 but 6/10 CT STABLE, PET improving. Markers normal. Brain NED. Resume just Herceptin plus ZOMETA
Dec 2010 Brain NED, lungs/sternum stable. markers normal.
MAR 2011 stop Herceptin/allergy! Go back on Tykerb and switch to Xgeva.
May-Aug 2011 Tykerb Herceptin Xgeva.
Sept 2011 Tykerb, Herceptin, Zometa, Avastin.
April 2012 sketchy drug trial in NYC. 6 weeks later I’m NED!
OCT 2012 PET/CT shows a bunch of freakin’ progression. Back to LA and Herceptin.avastin.zometa.
12/20/12 add in PERJETA!
March 2013 – 5 YEARS POST continue HAPZ
APRIL 2013 - 6 yrs stage 4. "FAILED" PETscan on 4/2/13
May 2013: rePetted - improvement in lungs, left adrenal stable, right 6th rib inactive, (must be PERJETA avastin) sternum and L1 fruckin'worsen. Drop zometa. ADD Xgeva. Doc says get rads consultant for L1 and possible biopsy of L1. I say, no thanks, doc. Lets see what xgeva brings to the table first. It's summer.
June-August 2013HAPX Herceptin Avastin Perjeta xgeva.
Sept - now - on chemo hold for calming tummy we hope. Markers stable for 2 months.
Nov 2013 - Herceptin-Perjeta-Avastin-Xgeva (collageneous colitis, which explains tummy probs, added Entocort)
December '13 BRAIN MRI ned in da head.
Jan 2014: CONTINUING on HAPX…
FEB 2014 PetCT clinical “impression”: 1. newbie nodule - SUV 1.5 right apical nodule, mildly hypermetabolic “suggestive” of worsening neoplastic lesion. 2. moderate worsening of the sternum – SUV 5.6 from 3.8
3. increasing sclerosis & decreasing activity of L1 met “suggests” mild healing. (SUV 9.4 v 12.1 in May ‘13)
4. scattered lung nodules, up to 5mm in size = stable, no increased activity
5. other small scattered sclerotic lesions, one in right iliac and one in thoracic vertebral body similar in appearance to L1 without PET activity and not clearly pathologic
APRIL 2014 - 6 YRS POST GAMMA ZAP, 7 YRS MBC & 18 YEARS FROM ORIGINAL DX!
October 2014: hold avastin, continue HPX
Feb 2015 Cancer you lost. NEDHEAD 7 years post gamma zap miracle, 8 years ST4, +19 yrs original diagnosis.
Continue HPX. Adding back Avastin
Nov 2015 pet/ct is mixed result. L1 SUV is worse. Continue Herceptin/avastin/xgeva. Might revisit Perjeta for L1. Meantime going for rads consult for L1
December 2015 - brain stable. Continue Herceptin, Perjeta, Avastin and xgeva.
Jan 2016: 5 days, 20 grays, Rads to L1 and continue on HAPX. I’m trying to "save" TDM1 for next line. Hope the rads work to quiet L1. Sciatic pain extraordinaire :((
Markers drop post rads.
2/24/16 HAP plus X - markers are down
SCIATIC PAIN DEAL BREAKER.
3/23/16 Laminectomy w/coflex implant L4/5. NO MORE SCIATIC PAIN!!! Healing.
APRIL 2016 - 9 YRS MBC
July 2016 - continue HAP plus Xgeva.
DEC 2016 - PETCT: mets to sternum, lungs, L1 still about the same in size and PET activity. Markers not bad. Not making changes if I don't need to. Herceptin/Perjeta/Avastin/Xgeva
APRIL 2017 10 YEARS MBC
December 2017 - Progression - gonna switch it up
FEB 2018 - Kadcyla 3 cycles ---->progression :(
MAY30th - bronchoscopy, w/foundation1 - her2 enriched
Aug 27, 2018 - start clinical trial ZW25
JAN 2019 - ZW25 seems to be keeping me stable
APRIL 2019 - ONE DOZEN YEARS LIVING METASTATIC
MAY 2019 - progression back on herceptin add xeloda
JUNE 2019 - "6 mos average survival" LMD & CNS new single brain met - one zap during 5 days true beam SBRT to cord met
10/30/19 - stable brain and cord. progression lungs and bones. washing out. applying for ds8201a w nivolumab. hope they take me.
12/27/19 - begin ds8401a w nivolumab. after 2nd cycle nodes melt away. after 3rd cycle chest scan shows Improvement, brain MRI shows improvement, resolved areas & nothing new. switch to plain ENHERTU. after 4th cycle, PETscan shows mostly resolved or improved results. Markers near normal. I'm stunned but grateful.
10/26/20 - June 2021 Tucatinib/xeloda/herceptin - stable ish.
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Old 12-17-2007, 11:03 AM   #3
Lani
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I was totally exhausted attending the meetings, presentations outside of meeting hrs

poster sessions, etc during my 5 days in San Antonio and my flight was delayed and I had 8 minutes to transfer from one flight to the other with my luggage not making it onto the plane with me. My luggage was delivered at 3 am, hence my posting in the wee hours.

It will take me to unpack the bags, find my notes, before even thinking of posting the names(with the exception of the author of my "favorite paper"...In my tiredness I mused that this was sort of like a singing, dancing or beauty contest, where half the fun is in the anticipation of finding out who one. The author of my favorite paper was the only one who felt she first had to check with her institution as to how it best be done and who encouraged me to find out how many of you are activist "warriors" rather than sheep who find it more comfortable to follow. (Nothing wrong with sheep, in fact I am very fond of them!)

Nevertheless, I have been disappointed to see yours as the only reply to my thread so far. I see this project as of monumental importance if the her2support group steps up to the bat and
participates fully. It would be groundbreaking and pioneering if it were to come to fruition.

Five days away from home has left much undone. And I will be more useful to the task once I have rested.

A few "thanks for your efforts in talking to all these people" and "please, please end the anticipation and let us know who these researchers may be so we can get this project on its way" would have gone a long way. But the morning is still young...
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Old 12-17-2007, 11:39 AM   #4
StephN
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Wink Where can we take this?

Dear Lani -
We have not forgotten your "mission" in San Antonio. In my case I am just trying to digest ALL the new information that has been posted here in the past week, as well as waiting for you to get unpacked and find your information.

As one who as attended the San Antonio symposium twice, I totally understand how the high energy and constant presentations can affect one's ability to keep every last detail straight. Personally, I have never experienced such an intense energy level as felt at that symposium.

It is like people's brains are bouncing off one another. There is important and stimulating conversation at every turn. Information overload is very easy to attain, and you went the extra mile to seek out presenters and researchers that might want to leap ahead with HER2 research.

THANKS!
__________________
"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 12-17-2007, 11:51 AM   #5
SoCalGal
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Okay- fair enough - then I apologize.

Lani, I think that many people feel gratitude for your efforts. The "please, please end the anticipation..." is too abstract - your post is not as crystal clear to the board as it is to you. I am pretty bright and resourceful so I feel that if I don't know how to move it forward or how to respond, or interpret, or what to do next, then most also won't know. Don't forget that many here are chemo'd out, greatly fatigued, fighting depression, etc. I don't know if you've ever done chemo, but I'm guessing that if you haven't you've witnessed it firsthand. You seem to do a lot of traveling and sure have the brain power with regard to research and ideas - you are lucky for that intense level of focus. We are also lucky that you post here. Remaining anonymous works against you. Not a judgement, just an observation. It keeps people at bay. People on this board "get naked" with one another. We have nothing to fear and nothing to lose. We already have cancer, how much worse could things be if we really "knew" one another?

People respond best when there is something very tangible and specific asked of them. Even something as important as this project involves "marketing". I think we need a small group of people who can work on this together to make it a reality. These woman would respond if it was more clear what needed to be done. Maybe a conference call to see what's realistic and how we can make "it" happen. Lani, even as I type this I am just exhausted but I would help to coordinate your efforts or do what you thought would be helpful.

After you are home from S.A. perhaps some personal emails to the few people that you think could move it forward would be good. Then we can use the board to give specifics. I don't know how to use the information and run with it but I think that you might know. Hope you have a good day today. Say hi to Joe, Christine and Brenda if you see them. --Flori
__________________
1996 cancer WTF?! 1.3 cm lumpectomy Er/Pr neg. Her2+ (20nodes NEGATIVE) did CMF + rads. NED.
2002 recurrence. Bilateral mastectomy w/TFL autologous recon. Then ACx2. Skin lymphatic rash. Taxotere w/Herceptin x4. Herceptin/Xeloda. Finally stops spreading.
2003 - Back to surgery, remove skin mets, and will have surgery one week later when pathology can confirm margins.
‘03 latisimus dorsi flap to remove skin mets. CLEAN MARGINS. Continue single agent Herceptin thru 4/04. NED.
‘04 '05 & 06 tiny recurrences - scar line. surgery to cut out. NED each time.
1/2006 Rads again, to scar line. NED.

3/07 Heartbreaking news - mets! lungs.sternum. Try Tykerb/Xeloda. Tykerb/Carbo/Gemzar. Switch Oncs.
12/07 Herceptin.Tykerb. Markers go stable.
2/8/08 gamma knife 13mm stupid brain met.
3/08 Herceptin/tykerb/avastin/zometa.
3/09 brain NED. Lungs STABLE.
4/09 attack sternum (10 daysPHOTONS.5 days ELECTRONS)
9/09 MARKERS normal!
3/10 PET/CT=manubrium intensely metabolically active but stable. NEDhead.
Wash out 5/10 for tdm1 but 6/10 CT STABLE, PET improving. Markers normal. Brain NED. Resume just Herceptin plus ZOMETA
Dec 2010 Brain NED, lungs/sternum stable. markers normal.
MAR 2011 stop Herceptin/allergy! Go back on Tykerb and switch to Xgeva.
May-Aug 2011 Tykerb Herceptin Xgeva.
Sept 2011 Tykerb, Herceptin, Zometa, Avastin.
April 2012 sketchy drug trial in NYC. 6 weeks later I’m NED!
OCT 2012 PET/CT shows a bunch of freakin’ progression. Back to LA and Herceptin.avastin.zometa.
12/20/12 add in PERJETA!
March 2013 – 5 YEARS POST continue HAPZ
APRIL 2013 - 6 yrs stage 4. "FAILED" PETscan on 4/2/13
May 2013: rePetted - improvement in lungs, left adrenal stable, right 6th rib inactive, (must be PERJETA avastin) sternum and L1 fruckin'worsen. Drop zometa. ADD Xgeva. Doc says get rads consultant for L1 and possible biopsy of L1. I say, no thanks, doc. Lets see what xgeva brings to the table first. It's summer.
June-August 2013HAPX Herceptin Avastin Perjeta xgeva.
Sept - now - on chemo hold for calming tummy we hope. Markers stable for 2 months.
Nov 2013 - Herceptin-Perjeta-Avastin-Xgeva (collageneous colitis, which explains tummy probs, added Entocort)
December '13 BRAIN MRI ned in da head.
Jan 2014: CONTINUING on HAPX…
FEB 2014 PetCT clinical “impression”: 1. newbie nodule - SUV 1.5 right apical nodule, mildly hypermetabolic “suggestive” of worsening neoplastic lesion. 2. moderate worsening of the sternum – SUV 5.6 from 3.8
3. increasing sclerosis & decreasing activity of L1 met “suggests” mild healing. (SUV 9.4 v 12.1 in May ‘13)
4. scattered lung nodules, up to 5mm in size = stable, no increased activity
5. other small scattered sclerotic lesions, one in right iliac and one in thoracic vertebral body similar in appearance to L1 without PET activity and not clearly pathologic
APRIL 2014 - 6 YRS POST GAMMA ZAP, 7 YRS MBC & 18 YEARS FROM ORIGINAL DX!
October 2014: hold avastin, continue HPX
Feb 2015 Cancer you lost. NEDHEAD 7 years post gamma zap miracle, 8 years ST4, +19 yrs original diagnosis.
Continue HPX. Adding back Avastin
Nov 2015 pet/ct is mixed result. L1 SUV is worse. Continue Herceptin/avastin/xgeva. Might revisit Perjeta for L1. Meantime going for rads consult for L1
December 2015 - brain stable. Continue Herceptin, Perjeta, Avastin and xgeva.
Jan 2016: 5 days, 20 grays, Rads to L1 and continue on HAPX. I’m trying to "save" TDM1 for next line. Hope the rads work to quiet L1. Sciatic pain extraordinaire :((
Markers drop post rads.
2/24/16 HAP plus X - markers are down
SCIATIC PAIN DEAL BREAKER.
3/23/16 Laminectomy w/coflex implant L4/5. NO MORE SCIATIC PAIN!!! Healing.
APRIL 2016 - 9 YRS MBC
July 2016 - continue HAP plus Xgeva.
DEC 2016 - PETCT: mets to sternum, lungs, L1 still about the same in size and PET activity. Markers not bad. Not making changes if I don't need to. Herceptin/Perjeta/Avastin/Xgeva
APRIL 2017 10 YEARS MBC
December 2017 - Progression - gonna switch it up
FEB 2018 - Kadcyla 3 cycles ---->progression :(
MAY30th - bronchoscopy, w/foundation1 - her2 enriched
Aug 27, 2018 - start clinical trial ZW25
JAN 2019 - ZW25 seems to be keeping me stable
APRIL 2019 - ONE DOZEN YEARS LIVING METASTATIC
MAY 2019 - progression back on herceptin add xeloda
JUNE 2019 - "6 mos average survival" LMD & CNS new single brain met - one zap during 5 days true beam SBRT to cord met
10/30/19 - stable brain and cord. progression lungs and bones. washing out. applying for ds8201a w nivolumab. hope they take me.
12/27/19 - begin ds8401a w nivolumab. after 2nd cycle nodes melt away. after 3rd cycle chest scan shows Improvement, brain MRI shows improvement, resolved areas & nothing new. switch to plain ENHERTU. after 4th cycle, PETscan shows mostly resolved or improved results. Markers near normal. I'm stunned but grateful.
10/26/20 - June 2021 Tucatinib/xeloda/herceptin - stable ish.
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Old 12-17-2007, 12:25 PM   #6
Sheila
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Lani
Its too bad you didn't take the time to stop by our booth and meet each of us that went to San Antonio....we are quite a team! As last year, the information is exhausting and overwhelming but so worth it.
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is fighting some kind of battle."



Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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Old 12-17-2007, 01:00 PM   #7
hutchibk
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Sheila - I am betting that she did stop by our booth - but we didn't know it. I believe she is hoping to retain her "incognito" status.

Flori and all - I think I tuned in to much of the info that Lani is talking about at SABCS, and I too wait with baited breath for her distillation of the very powerful developments and research regarding HER2. There are some very elegant researchers working on breaking the code of our particular subset of the disease. There was so much that I found to be over the moon optimistic about, but I have no idea how to translate it accurately. All I know is that I heard two researchers use the phrase "on path to potential cure" and I know that they didn't say it lightly. Those are strong words to use in such a setting. But they are breaking the complex code and network of HER1, 2, 3, 4 and the synergy and escape hatches that those genes/proteins have heretofore used to proliferate. There are some very smart theories out there and we as patients in the immediate might be able to offer something that can contribute greatly to advancing those theories. It would be generous of us to give Lani a moment to catch her breath to congeal the info she acquired, so that she can present it to us in an understandable way. For her to be there acting on our behalf so directly with the researchers is a generousity that I can hardly wrap my mind around... All I can think to say is, THANK YOU Lani. (I actually smiled at her attempt at ironic humor due to her exhaustion. I knew exactly what she meant... that she knew it might be a little cruel to have only the energy to post a small taster of the info she acquired, for those of us waiting with baited breath - but she was excited and wanted everyone to know that there is much to be excited about and that she has every intention to post the nitty gritty details at her very earliest opportunity. It was not malicious, just a stab at gently irony.)
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Brenda

NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."
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Old 12-17-2007, 02:49 PM   #8
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still regathering my strength, but here is a preliminary list

Dr. Rachel Schiff of Baylor has worked with Dr. C. Kent Osborne and Graciela Arpino and their team have published much of the original work on AIs working better than tamoxifen for those who are ER+ but PR-, as well as work on the second, faster acting estrogen receptor which sits on the cytoplasmic membrane rather than inside the nucleus and crosstalks with her2 as well as the wonderful study on CURING her2 breast cancer in mice using the triple cocktail of pertuzumab, herceptin and IRESSA (an oral tyrosine kinase inhibitor against EGFR aka her1). Dr. Osborne presented a very elegant talk on how the her family (1,2,3 and 4) and their ligands(the compounds which attach to the receptors and activate them) and ER and IGFR and others crosstalk and how tamoxifen, estrogen depletion (AIs) and others combine with her family inhibitors and how attacking 3 to 4 pathways simultaneously appears to exhaust the cancer's means of escape (I liken cancer to a puppy that wants to go outside and play.. you can shut the front door, but it will find the back door, the door to the garage, and perhaps the playroom door to escape out of if you don't close them all...hopefully the puppy tuckers out and gives up after checking out 3 or 4!) Also at her institution, Baylor, is Jenny Chang whose paper was the last given yesterday. Max Wicha, stem cell theory of breast cancer advocate par excellence, discussed how ER was not on the stem cell but rather on the progenitor cell (can explain this later in more detail--remind me!) and how the role of her2 was to turn a switch which caused there to be a higher percentage of stem cells within the tumor. This was born out by Dr. Chang's neoadjuvant study in which she gave patients lapatinib only after an initial biopsy that showed her2+ breast cancer. After the lapatinib she took a second biopsy and after that, gave chemo and herceptin and a third biopsy.

The second biopsy showed a decreased percentage of cancer stem cells than the first (wish she had done another study with herceptin only first, and then lapatinib with chemo and another with just herceptin then lapatinib, lapatinib and then herceptin and a third with both together...oh well!)

These cancer stem cells are felt to be the only ones within the tumor capable of making cancer recur and to hide out like mildew in your shower after you use bleach containing cleaner...because they are dormant and hide in the form of their protective spore, in the case of mildew, or in their
hidden niche in bone marrow, brain, etc and multiply only rarely, like life in the desert which blooms only after the very rare rains...they are not killed by treatments which rely on the cell dividing to kill them (virtually all chemos). Dr. Wicha has formed a company with Dr. Clarke, the discoverer of the breast cancer stem cell and within the last 10 days it got an enormous infusion of funding from GlaxoSmithKlein according to the Wall Street Journal.

So whether or not you personally believe in the stem cell theory of breast cancer, this institution (Baylor) has researchers at the very pinnacle of her2+ breast cancer research--there are already drugs in development which target stem cell markers and these triple cocktails seem according to most of the leading cancer researchers to be the best hope of taming the beast(please forgive me for comparing it to a puppy, I don't want to insult puppies, just to show that it is very determined and used to getting its own way!) Some drugs which are already FDA approved may turn out to work.

If you can access the Wall Street Journal there is a great article about patients trying to "mix their own cocktails" to cure their/or their children's cancers(not something that I am advocating).

Dr. Schiff did not want to commit herself to do anything but check into what institutional paperwork and protocols might apply until I could assure her that we truly had dedicated patients who intended to fulfil their promise to
provide their specimens( usually $70 to provide much more than they need, so hopefully less and perhaps we can get a grant) and histories (usually just takes a faxed copy of your signature to the department of medical records allowing them to obtain your mammos/xrays/mris and or their reports, lab tests, operative reports, clinic notes, etc.)

I will see if a pre-med I know would like to take this up...would look great on a resume and will check with my local breast cancer advocate organisation to see if they have any volunteers. But there is no point in going further if the samples and medical records releases are not going to materialize.

Perhaps Alaska Angel or Rhonda could start a thread asking who would give a small piece of their surgical specimens, any additional blood requested (if we can get the costs deferred and get it drawn locally), any additional swabbing of the mouth (who knows, they might ask for it) for genetic
material for testing, and who would be willing to give them access (privacy maintained) to your medical records. Something with a colorful graph for yes, no vs maybe might do the trick!

I think it would be a great memorial to those we have lost, an affirmation of hope for those still alive and an effort to prevent our daughters from having this burden hanging over them as well. I personally believe we are much closer to curing her2+ breast cancer than many other cancers which afflict so many. Our understanding of it is growing by leaps and bounds but it can be turbo-accelerated by providing the researchers with enough samples with matching histories to maximize their ability to sift through the various
directions the research is going and point it full-steam ahead in the right direction to benefit all as quickly as possible. A side effect may be to find cures for other cancers with similar behaviors (eg some esophageal cancers express her2).

Am still searching for the card of my second candidate, someone looking into the immunological aspect of her2+ breast cancer, but in the meantime I will provide you with the names of the London researcher and a researcher
in Alabama, who works with some present and past Stanford researchers.

The former is Aleksandra Filipovic, Imperial College London, UK. I will be calling and emailing her to get her to describe her research to you. The latter is Robert Seitz of Applied Genomics of Huntsville, Alabama and I will
have him provide a description of his research and how he would utilize the specimens and medical histories. I would prefer to provide our samples to
nonprofit entities such as universities (he works with university researchers), but as I recall his firm might be able to provide many here with information on their specific tumors, whether immunohistochemical or by gene expression profiling. This might help in the short term those deciding whether their tumor is more likely to respond to one targetted therapy or another. Again, I only had short conversations with the two above (vs Dr. Schiff with whom I have spoken, emailed previously) so I would like for them to further "sell themselves" to those who might wish to donate their specimens.

If you search the abstracts at SABCS you should be able to find that with Robert Seitz's name on it...

Got to get going...more later!
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Old 12-17-2007, 02:54 PM   #9
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don't know if you need a subscription to access this WSJ story

http://online.wsj.com/article/SB1197...e_health_right
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Old 12-17-2007, 02:56 PM   #10
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Thanks, thanks, thanks

Lani:

You are really the first person I think of when I think of someone that informed and willing to take the time to share their knowledge with us. I can NEVER thank you enough for ALL that you do. Please post more specific information about what and how to help you. Once I have specifics I can take them to my sister.

Please know Lani that I really, truly appreciate you!

Lisa
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double mastectomy 6/9/06;
TCH started 7/12/06
last chemo 10/25/06
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Old 12-17-2007, 06:55 PM   #11
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I need to email these people and get their synopsis of what they are

doing and how your specimens can help. I want their proposals in their own words so that those here who may volunteer their specimens/histories understand the research goals and perhaps can decide which if any of these project they want to contribute their tissues to. These emails must be worded in a diplomatic fashion.

As you know, people always wonder what kind of personal gain is behind
an offer of this kind...sort of sad in a country with a long history of volunteerism. That is why it was so worthwhile personally approaching these people face-to-face so that each could appreciate the others veracity, motivations and humanity.

I am now unpacking to find the card of the 4th researcher (the one interested in the immune system's role in her2+ breast cancer) as well as the posters of the Alabama researcher and the immune researcher so I can place the links here so you can get a taste of what these people have already done. I hope they will provide me with a list of what they hope to do. The researcher from London was not a speaker or poster presenter... we happened to be looking at the poster of the gentleman from Alabama during the period I was discussing the possibility of providing samples/histories

I will also be eagerly awaiting their email replies to see how eloquent they can be in presenting their research goals.
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Old 12-17-2007, 07:11 PM   #12
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here is the poster of the gentleman from Alabama

although some of the authors are from a for profit organization, others are from Roswell Park Cancer Institute, a highly respected institution and perhaps that is the way to go???

http://www.abstracts2view.com/sabcs/...u=SABCS07L_750
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Old 12-17-2007, 11:35 PM   #13
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Question The collection and availability of information

Lani,

I think we share a passion for figuring out the best way to set something up for a registry, and have one question to start with that maybe you can help to answer. I would prefer to e-mail you or PM you but that access is not available.

However, first I would like to provide some information to help demonstrate my commitment to such a project. As part of the clinical trial process, at mostly my own expense I have been donating blood samples every 3-4 months for several years now for research. The purpose is to find better markers; the blood is used to find better markers for both breast cancer and ovarian cancer. As part of this investigation, my medical records are open to the researchers who use my blood samples.

Completely separate from that clinical trial process, I was accepted for another trial that is sponsored by one of the pharmaceutical companies and offered via a large number of reputable researchers around the world, which in addition to blood sampling required tumor sampling. This trial also provided access to my medical records. For various reasons I have not participated in this trial, but the collection of the samples and information about me was provided for analysis to those conducting the trial.

Is this mass of raw, pre-trial information about the participating HER2's entirely already freely available to the many researchers responsible around the world? Or is it typically restricted to direct analysis only by the pharmaceutical company staff, and kept by the pharmaceutical company?

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Old 12-18-2007, 03:55 AM   #14
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Alaska Angel

I never doubted your commitment to this project-when I suggested it you "scooped it up and adopted it" with a passion

I was hoping to

1) get from Joe the number of registered "users" vs psters vs some idea of the number of lurkers if it is possible to determine those. to provide to those
insititutions/researchers we are approaching


2)get an idea of how many would come forward and agree to provide the specimens and history.

Many months/years ago I asked theoretically how many would agree if their treating physician would do a bone marrow biopsy to determine if it could determine whether the treatment they had had was sucessful (as an alternative to neoadjuvant therapy for those whose tumors were too small for that or who were not treated that way ie, surgeon did not consider that before doing the surgery and THEN referring them to an oncologist who would have considered treating them that way). Those treated with neoadjuvant therapy get to see whether the treatment they received worked (at least initially, no guarantees that resisitance did not develop later or that some cells remained dormant and unaffected to reappear later --putative cancer stem cells)and try another if it did not vs those whose treatment occurred after the tumor had been removed, who just had to hope the treatment picked was the right one and "wait for something to happen" whether fracture, bone pain or signs/symptoms of liver, brain or lung metastases.

Studies from Germany have shown that certain markers on isolated tumor cells found in sampled bone marrow of those in Stages I,II, nd III are excellent predictors of those with poor prognosis whose treatment should be the most agressive and probably whose treatment should be the most targetted as these are very very very slowly dividing cells than chemotherapy affects the least.

Graphs of those with her2+ tumor cells in their bone marrow or uPai/uPar
on their cells are among those with the worst prognosis, according to these researchers (put Pantel K into PubMed or Google and look at related articles in PubMed as well). These tests are commercially available.


I DID NOT suggest bone marrow sampling as part of THIS REGISTRY project as it involves a surgical procedure (although a small one--with the first done under anaesthesia at the time of initial surgery to determine a baseline ie if they are there from the start,and another one at the end of treatment) although I think it would be an important study to do on larger numbers of patients. Hopefully they will do it in Germany where there is government sponsored/assisted health insurance to pay for the procedure and where there doctors seem more inclined to suggest it . Most researchers I have asked about this seem to
think patients wouldn't agree to it. but I am not sure if it is the patients or their own preferences (it is one of few invasive procedures they do and perhaps they don't like to) which direct their view.

(Perhaps Madubois could chime in on this as she is probably one of few here who has had this procedure and could present her opinion in an informed way.)

A few on the board at that time (when I asked how many theoretically would consider having their bone marrows sampled) thought it sounded like a good idea and theoretically thought they might.



Even though the bone marrow sampling question was something I personally have wondered about, as I tend to be a believer in the stem cell theory of breast cancer, I knew I was
trying to represent those here in honoring those they had lost and creating hope for themselves and their daughters by offering the registry and looked to talk to those most likely to the type of research with it they might have wanted.


Therefore,THIS TIME THE IDEA was MORE PRACTICAL--NO ADDITIONAL INVASIVE PROCEDURE required unless one wanted to give blood samples.


Now a day and a half after returning from SABCS , and with a bit more perspective...and not as many responses as I would have liked-- I am tendiing to rethink the original plan.

Perhaps we could make a repository of the tissue donated at one or two institutions--one in the US and one in the UK or other EU country--and allow them to subdivide the treasure and serve as a lending library.



With a bit more rest and reflection I now realize that on my last two visits to SABCS I have met someone who could really help me with this. He was a representative of an organization which provides samples for researchers. He was from the Department of Pathology at Washington University in Saint Louis. I had not thought to ask someone, even theoretically, what institutions/mechanics are already in place for such things before starting off on my "matchmakers" quest with the poster presenters/speakers.

As I am truly a fish out of water dealing with -- I should have followed my usual inclination which is to "do an apprenticeship" by approaching others who do something similar and learning from them first.

Looks like I have lots of homework. Still working on those emails, working to find the card of the immunological researcher, and now getting in touch with this person at Washington University.

Try to be patient, but in the meantime I would appreciate if those like Alaska Angel who pledge they REALLY WOULD (rather than theoretically would like to think they would) provide their tumor samples and history (and those who would be willng to provide addditional blood samples or mouth swabs as well come forward and declare yourselves and or post your misgivings and under what conditions you would consider participating.

I would appreciate if others would look into the logistics/paperwork required from a legal point of view (?Cynthia)m from the point of view of those on this board, as Baylor will probably come up with their own paperwork and someone must determine if its wording is in the best interest of those contributing and perhaps if any funding might be forthcoming (?Joe). I originally proposed this project when Alaska lost a dear friend as a living memorial, and I followed through to try to give birth to this registry. But I think others should come forward to "deliver" it and help it through its infancy.

I am not qualified medically, scientifically or legally to remain in charge of this project so I would appreciate others signing up to help "adopt the baby and help rear it through its infancy and childhood" Hopefully it will last a long time and we find others tol have to deal with its teenage years!

If we can't find the will to have this baby, let's throw the baby out with the bathwater early so I can move on to other things.

I won't send more than cursory emails to the researchers until I feel more assured this baby is not about to be aborted.
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Old 12-18-2007, 06:19 AM   #15
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I certainly didn't expect to see my name mentioned when I started reading this post. I haven't even had my tea yet.

I don't think people have replied because this is a lot of information to take in at a time when most are too harried to think so seriously. I am still healing from my latest surgery and trying to shop, wrap, bake and do all the normal things I didn't get to do over the last two weeks. I am sure I am not the only busy person around here. Anyway...

As to the bone marrow biopsy, they hurt! I have had 5 or 6. I try to block them out of my memory. Would I do another for reseach? Absolutely! I have had several done by several different doctors. If we could all have them done by my Sylvia (Nurse Practitioner), we'd all be in good hands. If they were all done by my leukemia onc, I'd say run...

I am all for research - even if it doesn't help me at all. I have a daughter, a son and 2 nephews I do not want to ever see sick! I have had an unmarked van come to my house and collect blood (gov't), I've signed over my medical records for research twice (Inflammatory and leukemia), gave over my original pathology slides, filled out tons of surveys and just last week gave two big vials of blood and signed over my medical records again for new research.

In my opinion, the best way to get a larger number of people to participate is to have this done through thier oncologists office while other tests are already being done. Maybe a packet could be put together and taken to your onc during an already scheduled appointment. Last weeks blood donation for research was done while I was already accessed for my normal blood tests. My original slides are 8 years old, but are still stored at my cancer hospital. I'm not sure about how long they save the bone marrow biopsies, but I am sure mine can still be obtained if needed. The cost of something like this could be astrimnomical, but if previous tests can be used, I am sure it would save a lot of time, money and hassle.
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Old 12-18-2007, 06:26 AM   #16
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Lani - Like I said, I still haven't even had my morning tea...Have you participated in other research programs? Maybe trying a few out will help get the info you need. I re-read your post and remembered doing the swabs of the cheek a few years back. I am sure I have copies of the info packets for at least two of the different research programs I participated in. I will look for them. Write me personally with your address, and I will make copies and send them to you if you'd like.
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Old 12-18-2007, 09:44 AM   #17
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When I was qualifying for the vaccine trial at UW, they fed ex'ed a packet for me to take to my onc appointment. At the appointment, they did a blood draw (due for labs anyway) and the nurse followed the directions in the packet (a form and vials to be filled) and then fed exed it back to the UW lab. That was easy.

I have my tumor slides at home. Is this sufficient for a tumor sample?
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Old 12-18-2007, 10:13 AM   #18
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I had posted this as a reply to another post..

I wish that you had spoken to me in San Antonio as I have been discussing a similar project for several months. I could have introduced you to others who recognize the collection of tissue and serum samples will provide a great deal of data which may lead to the eradication of HER positive cancer. There is also another reason why 2008 would be an opportune time to launce such a project.

As you are well aware, research projects require a great deal of funding and planning, both of which are beyond our scope and financing. I would have no problem with members launching such an initiative and will also offer to construct and host a website for that purpose.

You on the other hand would have to formally construct a study plan to submit along with Grant requests as such an project would require hundreds of thousands of dollars. There is ample funding available through Avon, Komen, Armstrong and other entities.

California has a great program which would partially fund such a study and the State of Texas has recently authorized a cancer research program.

The HER2 Support Group currently holds a very unique status with cancer researchers and enjoys an exceptional reputation. We would act as the sponsoring organization.

A first step might be to host a conference call with all interested parties.

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Old 12-18-2007, 10:19 AM   #19
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Just to reiterate, I'm all in.

I just started w/a new onc and will discuss the project at my next visit. She is a woman of power and action - perhaps she'll have an idea on logistics.

After the first of the year I will have more time and hopefully feel better and can do more.

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1996 cancer WTF?! 1.3 cm lumpectomy Er/Pr neg. Her2+ (20nodes NEGATIVE) did CMF + rads. NED.
2002 recurrence. Bilateral mastectomy w/TFL autologous recon. Then ACx2. Skin lymphatic rash. Taxotere w/Herceptin x4. Herceptin/Xeloda. Finally stops spreading.
2003 - Back to surgery, remove skin mets, and will have surgery one week later when pathology can confirm margins.
‘03 latisimus dorsi flap to remove skin mets. CLEAN MARGINS. Continue single agent Herceptin thru 4/04. NED.
‘04 '05 & 06 tiny recurrences - scar line. surgery to cut out. NED each time.
1/2006 Rads again, to scar line. NED.

3/07 Heartbreaking news - mets! lungs.sternum. Try Tykerb/Xeloda. Tykerb/Carbo/Gemzar. Switch Oncs.
12/07 Herceptin.Tykerb. Markers go stable.
2/8/08 gamma knife 13mm stupid brain met.
3/08 Herceptin/tykerb/avastin/zometa.
3/09 brain NED. Lungs STABLE.
4/09 attack sternum (10 daysPHOTONS.5 days ELECTRONS)
9/09 MARKERS normal!
3/10 PET/CT=manubrium intensely metabolically active but stable. NEDhead.
Wash out 5/10 for tdm1 but 6/10 CT STABLE, PET improving. Markers normal. Brain NED. Resume just Herceptin plus ZOMETA
Dec 2010 Brain NED, lungs/sternum stable. markers normal.
MAR 2011 stop Herceptin/allergy! Go back on Tykerb and switch to Xgeva.
May-Aug 2011 Tykerb Herceptin Xgeva.
Sept 2011 Tykerb, Herceptin, Zometa, Avastin.
April 2012 sketchy drug trial in NYC. 6 weeks later I’m NED!
OCT 2012 PET/CT shows a bunch of freakin’ progression. Back to LA and Herceptin.avastin.zometa.
12/20/12 add in PERJETA!
March 2013 – 5 YEARS POST continue HAPZ
APRIL 2013 - 6 yrs stage 4. "FAILED" PETscan on 4/2/13
May 2013: rePetted - improvement in lungs, left adrenal stable, right 6th rib inactive, (must be PERJETA avastin) sternum and L1 fruckin'worsen. Drop zometa. ADD Xgeva. Doc says get rads consultant for L1 and possible biopsy of L1. I say, no thanks, doc. Lets see what xgeva brings to the table first. It's summer.
June-August 2013HAPX Herceptin Avastin Perjeta xgeva.
Sept - now - on chemo hold for calming tummy we hope. Markers stable for 2 months.
Nov 2013 - Herceptin-Perjeta-Avastin-Xgeva (collageneous colitis, which explains tummy probs, added Entocort)
December '13 BRAIN MRI ned in da head.
Jan 2014: CONTINUING on HAPX…
FEB 2014 PetCT clinical “impression”: 1. newbie nodule - SUV 1.5 right apical nodule, mildly hypermetabolic “suggestive” of worsening neoplastic lesion. 2. moderate worsening of the sternum – SUV 5.6 from 3.8
3. increasing sclerosis & decreasing activity of L1 met “suggests” mild healing. (SUV 9.4 v 12.1 in May ‘13)
4. scattered lung nodules, up to 5mm in size = stable, no increased activity
5. other small scattered sclerotic lesions, one in right iliac and one in thoracic vertebral body similar in appearance to L1 without PET activity and not clearly pathologic
APRIL 2014 - 6 YRS POST GAMMA ZAP, 7 YRS MBC & 18 YEARS FROM ORIGINAL DX!
October 2014: hold avastin, continue HPX
Feb 2015 Cancer you lost. NEDHEAD 7 years post gamma zap miracle, 8 years ST4, +19 yrs original diagnosis.
Continue HPX. Adding back Avastin
Nov 2015 pet/ct is mixed result. L1 SUV is worse. Continue Herceptin/avastin/xgeva. Might revisit Perjeta for L1. Meantime going for rads consult for L1
December 2015 - brain stable. Continue Herceptin, Perjeta, Avastin and xgeva.
Jan 2016: 5 days, 20 grays, Rads to L1 and continue on HAPX. I’m trying to "save" TDM1 for next line. Hope the rads work to quiet L1. Sciatic pain extraordinaire :((
Markers drop post rads.
2/24/16 HAP plus X - markers are down
SCIATIC PAIN DEAL BREAKER.
3/23/16 Laminectomy w/coflex implant L4/5. NO MORE SCIATIC PAIN!!! Healing.
APRIL 2016 - 9 YRS MBC
July 2016 - continue HAP plus Xgeva.
DEC 2016 - PETCT: mets to sternum, lungs, L1 still about the same in size and PET activity. Markers not bad. Not making changes if I don't need to. Herceptin/Perjeta/Avastin/Xgeva
APRIL 2017 10 YEARS MBC
December 2017 - Progression - gonna switch it up
FEB 2018 - Kadcyla 3 cycles ---->progression :(
MAY30th - bronchoscopy, w/foundation1 - her2 enriched
Aug 27, 2018 - start clinical trial ZW25
JAN 2019 - ZW25 seems to be keeping me stable
APRIL 2019 - ONE DOZEN YEARS LIVING METASTATIC
MAY 2019 - progression back on herceptin add xeloda
JUNE 2019 - "6 mos average survival" LMD & CNS new single brain met - one zap during 5 days true beam SBRT to cord met
10/30/19 - stable brain and cord. progression lungs and bones. washing out. applying for ds8201a w nivolumab. hope they take me.
12/27/19 - begin ds8401a w nivolumab. after 2nd cycle nodes melt away. after 3rd cycle chest scan shows Improvement, brain MRI shows improvement, resolved areas & nothing new. switch to plain ENHERTU. after 4th cycle, PETscan shows mostly resolved or improved results. Markers near normal. I'm stunned but grateful.
10/26/20 - June 2021 Tucatinib/xeloda/herceptin - stable ish.
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Old 12-18-2007, 12:21 PM   #20
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here is the last researcher--the antibody signatures she has detected seem to predict

breast cancer years before it becomes clinically detectible:

Tumor Glycome Laboratories of the NIH Alliance of Glycobiologists for Detection of Cancer and Cancer Risk

The National Cancer Institute is funding an initiative to discover, develop, and clinically validate cancer biomarkers based on complex carbohydrate structures attached to proteins and lipids. Seven Tumor Glycome Laboratories are searching for glycan-based biomarkers for breast, ovarian, lung, prostate, and pancreatic cancers and melanoma.
Numerous studies comparing normal and tumor cells have shown that changes in glycan structures on the cell correlate with cancer development. Compared to molecular proteins, molecular glycans are extremely abundant and recent advances in technology have now allowed the effective systematic study of these structures.
NCI's Tumor Glycome Laboratories are the principle component of the new trans-NIH Alliance of Glycobiologists for Detection of Cancer and cancer Risk. The other members of the Alliance are the Consortium for Functional the diagnosis of breast cancer years prior to diagnosis, or so she hopes

The NIH seems to feel her research is especially promising and her personal commitment, energy and the attitude I gleened from my conversations with her made her stand out in the way that a dog who wouldn't give up a slipper over its dead body ie, I doubt she will give up any promising research direction nor fail to pursue all others within her capability

Glycomics supported by the National Institute of General Medical Sciences and the Glycomics and Glycotechnology Resource Centers supported by the National Center for Research Resources.
The seven Tumor Glycome Laboratories are:
PROJECT TITLE
PRINCIPAL INVESTIGATOR
INSTITUTION OBJECTIVES OF PROJECT
(CANCER TYPE UNDER STUDY)
Discovery and clinical validation of cancer biomarkers using printed glycan array
Margaret Huflejt, Ph.D.
Cellexicon, Inc. Determine the diagnostic or prognostic anti-glycan auto-antibody signatures in patients and for breast cancer, determine how many years prior to diagnosis that progression to cancer can be predicted.
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