should herceptin be given earlier--before surgery and radiation therapy??

[Lani]

ABSTRACT: NK-cell and T-cell functions in patients with breast cancer: effects of surgery and adjuvant chemo- and radiotherapy [British Journal of Cancer]
Breast cancer is globally the most common malignancy in women. Her2-targeted monoclonal antibodies are established treatment modalities, and vaccines are in late-stage clinical testing in patients with breast cancer and known to promote tumour-killing through mechanisms like antibody-dependent cellular cytotoxicity. It is therefore increasingly important to study immunological consequences of conventional treatment strategies. In this study, functional tests and four-colour flow cytometry were used to detect natural killer (NK)-cell functions and receptors as well as T-cell signal transduction molecules and intracellular cytokines in preoperative breast cancer patients, and patients who had received adjuvant radiotherapy or adjuvant combined chemo-radiotherapy as well as in age-matched healthy controls. The absolute number of NK cells, the density of NK receptors as well as in vitro quantitation of functional NK cytotoxicity were significantly higher in preoperative patients than the post-treatments group and controls. A similar pattern was seen with regard to T-cell signalling molecules, and preoperative patients produced significantly higher amounts of cytokines in NK and T cells compared to other groups. The results indicate that functions of NK and T cells are well preserved before surgery but decrease following adjuvant therapy, which may speak in favour of early rather than late use of immunotherapeutic agents such as trastuzumab that may depend on intact immune effector functions.

[AlaskaAngel]

I'd wager that if any of us actually had the choice, it would be!

As I've said elsewhere before, there are many studies done on mice, etc. in regard to breast cancer, but how many of those studies used mice who had undergone surgery and conventional chemotherapies/radiation prior to being evaluated for new treatments? Doesn't it seem logical that promising results in mice end up being lost because they don't pan out in humans who have been put through toxic therapies and have lost some of their natural immune system defences?

AlaskaAngel