HonCode

Go Back   HER2 Support Group Forums > Articles of Interest
Register Gallery FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools Display Modes
Old 10-05-2013, 11:43 AM   #1
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Post Angiogenesis in Breast Cancer

This information is about 2 1/2 years old. NEDenise is on Avastin (bevacizumab). This helps us understand more about the history of this drug.

Almost all cancerous tumors, including breast cancer, require a blood supply in order to grow beyond a few millimeters in size. The growth of new capillary blood vessels from existing ones is a process called angiogenesis. In breast cancer, angiogenesis is known to begin at the earliest stages of tumor growth and continue unabated through progression to metastatic disease.2

Drugs that disrupt the tumor blood supply, called angiogenesis inhibitors, are dramatically altering the treatment landscape of some of the most common and feared cancer types. Antiangiogenic therapies are offering new hope to thousands of metastatic breast cancer patients, many of whom had few, if any, remaining treatment options.

Unlike conventional chemotherapy drugs that kill cancer cells directly, antiangiogenic drugs deprive cancer cells of essential oxygen and nutrients by blocking the formation of tumor blood vessels. By combining angiogenesis inhibitors with conventional chemotherapy and radiation, clinicians can now attack breast cancer from multiple directions, greatly improving the chances for treatment success. - See more at: http://www.scienceofcancers.org/brea....fXPIVMAc.dpuf

Last edited by 'lizbeth; 10-05-2013 at 12:02 PM.. Reason: Update
'lizbeth is offline   Reply With Quote
Old 10-05-2013, 11:44 AM   #2
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Post Re: Angiogenesis in Breast Cancer

Bevacizumab (Avastin®)
Bevacizumab (Avastin®) is an injectable monoclonal antibody that neutralizes a key angiogenesis-stimulating protein called vascular endothelial growth factor (VEGF). A major phase 3 clinical trial, known as E2100, conducted in metastatic breast cancer patients compared the combination of bevacizumab and paclitaxel, a taxane chemotherapy, to paclitaxel alone.3 Patients in this study were required to have breast cancer negative for human epidermal growth factor receptor-2 (HER-2), and could not have received prior breast cancer treatments.

The findings were dramatic: those who received the bevacizumab-paclitaxel combination lived twice as long without their disease worsening, known as progression-free survival, compared with patients who just received paclitaxel alone: 12 months compared with 6 months. Further, nearly half of women who received the bevacizumab-paclitaxel combination had their tumors shrink, compared with just over 20% of women who received single-agent paclitaxel.4

Based on these results, in February 2008 the U.S. Food and Drug Administration (FDA) granted accelerated approval for bevacizumab, in combination with paclitaxel, for the treatment of HER-2-negative metastatic breast cancer in patients who have received no prior treatment. Accelerated approval means that the FDA has granted preliminary approval for a drug for a specific indication pending more comprehensive data.

In July 2010, an independent panel that advises the FDA on cancer drugs recommended that the breast cancer indication for bevacizumab be revoked, citing more recent clinical data indicating that the potential risks of the drug, which can include side effects such as high blood pressure and bleeding, outweighed the benefits. A key factor in the panel’s decision was data from newer studies showing that bevacizumab slowed disease progression by only about a month, and did not help women live longer overall. The FDA accepted the panel's decision in December 2010.

In an unusual move, the manufacturer of bevacizumab appealed the FDA’s decision, which culminated in public hearings at the FDA in June 2011. During these hearings, breast cancer patients, oncologists, and advocacy groups argued that bevacizumab provided meaningful benefits, including improved quality of life and, in some cases, prolonged the lives of women with metastatic breast cancer for many months. Ultimately, however, the acting FDA Commissioner officially announced in November 2011 that the breast cancer labeling for bevacizumab was rescinded. Many private insurance companies, as well as the government-run health program Medicare, have indicated that for the time being they will continue to cover bevacizumab for breast cancer.

The manufacturer of bevacizumab is conducting an additional study of bevacizumab paired with the chemotherapy drug paclitaxel in patients with previously untreated metastatic breast cancer. The clinical trial includes a panel of pre-specified biomarkers that may help to better define which patients could most benefit from treatment with bevacizumab. Clinical trials are still the best way for breast cancer patients to gain access to experimental therapies, including antiangiogenic agents.
- See more at: http://www.scienceofcancers.org/brea....Ij2FlLCC.dpuf
'lizbeth is offline   Reply With Quote
Old 10-05-2013, 11:45 AM   #3
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Re: Angiogenesis in Breast Cancer

A number of orally administered antiangiogenic drugs are in development for metastatic breast cancer. Study results for most of these newer agents, however, are quite preliminary at this point. Sunitinib (Sutent®), an antiangiogenic drug approved to treat advanced kidney and liver cancer, showed promise in an initial study in metastatic breast cancer. However, a larger clinical trial was halted due to a higher than expected frequency of side effects in breast cancer patients who received sunitinib. Other clinical trials of sunitinib in metastatic breast cancer are ongoing.

Another oral agent approved to treat kidney and liver cancers, sorafenib (Nexavar®), is also being evaluated in several breast cancer studies. In one study, the combination of Sorafenib and capecitabine reduced the risk of metastatic breast cancer progression by 42%.9 In another study, a combination of sorafenib and paclitaxel improved progression-free survival by about 20%.10
- See more at: http://www.scienceofcancers.org/brea....dEx4g7xH.dpuf
'lizbeth is offline   Reply With Quote
Old 10-05-2013, 11:46 AM   #4
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Re: Angiogenesis in Breast Cancer

Up to 70% of patients with estrogen receptor-positive (ER-positive) breast cancer initially benefit from hormone therapy. A sizable percentage of patients, however, will become resistant to these treatments. Excessive angiogenesis may contribute to the development of resistance to hormone therapy in breast cancer patients with ER-positive tumors.12

Two recent clinical studies evaluated the safety and effectiveness of combining hormone therapy with antiangiogenic drugs. The first of these combined bevacizumab with letrozole (Femara®), a hormone therapy approved for use in postmenopausal women with early stage, hormone receptor-positive breast cancer following surgery. The study, which looked only at the safety of the drug combination, enrolled postmenopausal women with locally advanced or metastatic ER-positive breast cancer.13 The therapy was generally well tolerated, although some patients developed excess protein in the urine. A phase 3 clinical trial combining hormone therapy (letrozole or tamoxifen) with bevacizumab is underway.

Another small study combined sorafenib with the hormone therapy anastrozole (Arimidex®) in postmenopausal women with ER- and progesterone (PR) positive tumors.14 The participants in this study were resistant to prior hormone therapy. At follow-up, 20% of patients had some clinical benefit from the sorafenib-anastrozole combination. Five patients had their tumors stop growing for more than 24 weeks, and two patients experience tumor shrinkage for more than 6 months. - See more at: http://www.scienceofcancers.org/brea....oFUdtqEN.dpuf
'lizbeth is offline   Reply With Quote
Old 10-05-2013, 11:46 AM   #5
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Post Re: Angiogenesis in Breast Cancer

Certain oral chemotherapy drugs can be used as antiangiogenic agents when administered at low doses at regular, frequent intervals. This type of treatment, called metronomic chemotherapy, offers the advantages of more convenient dosing and less debilitating side effects than conventional infusion chemotherapy. The oral chemotherapy drugs cyclophosphamide and methotrexate are often used together as metronomic therapy for breast cancer. In a clinical study that tested this combination in metastatic breast cancer patients, 21% experienced at least some tumor shrinkage.15

A second small study evaluated metronomic dosing of cyclophosphamide and capecitabine plus bevacizumab.16 In this study, 48% of patients experienced at least partial regression of their tumors. A large multinational phase 3 trial is underway to compare the effectiveness of one year of metronomic cyclophosphamide and methotrexate therapy versus observation following surgery and adjuvant chemotherapy in stage I-III ER-negative breast cancer. - See more at: http://www.scienceofcancers.org/brea....5CUqCruF.dpuf
'lizbeth is offline   Reply With Quote
Old 10-05-2013, 11:48 AM   #6
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Re: Angiogenesis in Breast Cancer

Side effects of antiangiogenic cancer treatments are typically much milder and less debilitating than those of conventional chemotherapy agents. Elevated blood pressure (hypertension) is the most common side effect of bevacizumab treatment, and is treated with standard blood pressure medications. Other side effects of bevacizumab may include excess protein in the urine and mild blood clotting or bleeding problems. For this reason, bevacizumab must be used with caution in patients taking blood thinners. Much less frequently, patients on bevacizumab have experienced serious bleeding events, blood clots, impaired wound healing, bowel perforation, and kidney failure. Rarely, congestive heart failure has been reported in breast cancer patients treated with bevacizumab following or together with anthracycline chemotherapy.17

Side effects from oral antiangiogenic agents include diarrhea, fatigue, nausea, high blood pressure, and inflammation of the mucous membranes. Sunitinib and sorafenib can cause a number of skin toxicities, including painful calluses on the soles of the feet and palms of the hands, changes in hair color and texture, and small hemorrhages under the fingernails.18 Patients on sunitinib may require monitoring of thyroid function and for certain heart rhythm abnormalities.19, 20
- See more at: http://www.scienceofcancers.org/brea....4fCEWmQ0.dpuf
'lizbeth is offline   Reply With Quote
Old 10-05-2013, 11:49 AM   #7
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Re: Angiogenesis in Breast Cancer

References
1. American Cancer Society. Breast Cancer Facts & Figures 2011-2012.

2. Miller KD, Dul CL. Breast cancer: the role of angiogenesis and antiangiogenic therapy. Hematol Oncol Clin N Am 2004;18:1071-1086.

3. Miller K, Wang M, Gralow J, et al. Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med 2007;357:2666-2676

4. Gray R, Bhattacharya S, Bowden C, Miller K, Comis RL. Independent review of E2100: a phase III trial of bevacizumab plus paclitaxel in women with metastatic breast cancer. J Clin Oncol 2009;27:4966-4972.

5. Miles D, Chan A, Romieu L, et al. Randomized, double-blind, placebo-controlled, phase III study of bevacizumab with docetaxel or docetaxel with placebo as first-line therapy for patients with locally recurrent of metastatic breast cancer: AVADO. J Clin Oncol, Proc ASCO 2008;26:LBA1011.

6. Robert NJ, Dieras V, Brufsky GA, et al. RIBBON-1: randomized, double-blind, placebo-controlled, phase III trial of chemotherapy with or without bevacizumab for first-line treatment of HER-2-negative locally recurrent or metastatic breast cancer. J Clin Oncol 2009;27(15s):abstr 1005.

7. Miller KD, Chap LI, Holmes FA, et al. Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer. J Clin Oncol 2005;23:792-799.

8. Brufsky A, Bondarenko IN, Smirnov V, et al. RIBBON-2: A randomized, double-blind, placebo controlled, phase III trial evaluating the efficacy and safety of bevacizumab in combination with chemotherapy for second-line treatment of HER-2-negative metastatic breast cancer. SABCS; December 9-13, 2009:abstr. 42.

9. Baselga J, Costa F, Geulio MS, et al. SOLTI-0701: A multinational double-blind, randomized phase 2b study evaluating the efficacy and safety of sorafenib compared to placebo when administered in combination with capecitabine in patients with locally advanced or metastatic breast cancer. SABCS; December 9-13, 2009:abstr. 45.

10. Gradishar WJ, Kaklamani V, Prasad Sahoo T, et al. A double-blind, placebo-controlled phase 2b study evaluating the efficacy and safety of sorafenib in combination with paclitaxel as a first-line therapy in patients with locally recurrent or metastatic breast cancer. SABCS; December 9-13, 2009:abstr. 44.

11. Pegram M, Chan D, Dichmann RA, et al. Phase II combined biological therapy targeting the HER2 proto-oncogene and the vascular endothelial growth factor using trastuzumab and bevacizumab as first-line treatment of HER-2-amplified breast cancer. SABCS 2006:abstr. 3039.

12. Rydén L, Jirström K, Bendahl PO, et al. Tumor-specific expression of vascular endothelial growth factor receptor 2 but not vascular endothelial growth factor or human epidermal growth factor receptor 2 is associated with impaired response to adjuvant tamoxifen in premenopausal breast cancer. J Clin Oncol 2005;23:4695-4704

13. Traina TA, Rugo HS, Caravelli JF, et al. Feasibility trial of letrozole in combination with bevazcizumab in patients with metastatic breast cancer. J Clin Oncol. Published ahead of print, October 19, 2009.

14. Isaacs C, Wilkinson M, Liu MC, et al. Phase II study of sorafenib with anastrozole to overcome resistance to aromatase inhibitors in patients with hormone receptor positive (ER/PR+) AI resistant metastatic breast cancer. SABCS, December 9-13, 2009:abstr. 3090.

15. Colleoni M, Orlando L, Sanna G, et al. Metronomic low-dose oral cyclophosphamide and methotrexate plus or minus thalidomide in metastatic breast cancer: antitumor activity and biological effects. Ann Oncol 2006;17:232-238.

16. Dellepasqua S, Bertonloni F, Bagnardi V, et al. Metronomic cyclophosphamide and capecitabine combined with bevacizumab in advanced breast cancer. J Clin Oncol 2008;26:4899-4905.

17. Targeting Tumor Angiogenesis; Antiangiogenic therapy: tolerability and management of side effects. The Angiogenesis Foundation, Summer 2009.

18. Robert C, Soria JC, Spatz A, et al. Cutaneous side effects of kinase inhibitors and blocking antibodies. Lancet Oncol 2005;6:491-500.

19. Pfizer Inc. Sutent Prescribing Information. Available at: https://www.pfizeroncology.com/produ...indication.jsp. Accessed January 23, 2009.

20. Rini BI, et al. Hypothyroidism in patients with metastatic renal cell carcinoma treated with sunitinib. J Natl Cancer Inst 2007;99:81-83.
- See more at: http://www.scienceofcancers.org/brea....U6ow2ZJj.dpuf
'lizbeth is offline   Reply With Quote
Old 10-06-2013, 09:41 PM   #8
deb808
Member
 
Join Date: Oct 2012
Posts: 9
Re: Angiogenesis in Breast Cancer

Hi Elizabeth, I just wanted to reach out to thank you for all your posts and updates on treatment options... It's been very helpful to read this info while trying to navigate the stormy ocean of cancer. I'm sure you spend a lot of time gathering so much information and wanted to say thanks... It's difficult at times when fighting this disease to be able to get my hands on helpful links and your posts have been a beacon of light while I'm out in the storm... Just wanted to let you know how much I appreciated it
Many thanks,
Debbie
deb808 is offline   Reply With Quote
Old 10-07-2013, 12:08 PM   #9
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Re: Angiogenesis in Breast Cancer

Debbie,

I remember searching through everything I could find online and at the medical library when I was diagnosed in 2007 - so that I could avoid chemo and hopefully only do targeted therapy.

I recall how upset and confused I was trying to wrap my head around what my diagnosis really meant.

Most of all - cancer treatment really sucked, and it still does. Despite all the billions that has gone into finding a "cure".

I try and find information that is helpful and relevant. I'm glad you find it so.
'lizbeth is offline   Reply With Quote
Old 10-07-2013, 03:45 PM   #10
dearjilly
Senior Member
 
dearjilly's Avatar
 
Join Date: Feb 2012
Location: Ontario, Canada
Posts: 115
Re: Angiogenesis in Breast Cancer

Yes, lizbeth, thank you for ALL of the info. I will be reading and catching up on this important post for me.
So thanks so much for this my friend!
xoxoxo dearjilly
__________________
[
Feb 2013 - NED
Mar 2013 - thought I had progression, watching brain.
April 2013 - GOT MARRIED!!!!
May 2013 - looks like no progression, but necrosis and bigger.
Oct-Dec 2013 - Avastin tx
Nov 2013 - MRI shows necrosis shrinkage!!!!
Jan 2014 - Lepto Mening. disease found
Feb 2014 - WBR
March - BLAHHHH
April 2014 - Liver mets found
April 2014 to present - Chemo again, whooohoo. Fun!
July 2014, scans look good.
Stay on Perjetand hercertin.
Nov. 2014 more lepto-mening disease more WBR.
Feb 2015 more lepto-mening disease in spine and neck. More radiation.
Start on TDM1 no more Perjeta stay on herceptin
March 2015 more radiation in my thoracic area, more lepto-meningial disease
April 2015 trying to walk again.
[/SIZE][/FONT]
dearjilly is offline   Reply With Quote
Old 10-07-2013, 09:01 PM   #11
deb808
Member
 
Join Date: Oct 2012
Posts: 9
Re: Angiogenesis in Breast Cancer

Hey 'Lizbeth,

I know what you mean about trying to wrap your head around understanding this diagnosis. It seems there is also such a wide variation of Her2 subtypes and they're only scratchin the surface in some cases as far as understanding the hetergenous nature of this disease. I'm may have to look into another new treatment option for liver mets and will be searching to see what's available for my situation. I wish I could get access to the vaccine, but was told by my doctor that they want to see stability of disease before receiving it. I thought that I saw somewhere that you received it. I'd love to hear your thoughts about it.
Thank you again...
Debbie
deb808 is offline   Reply With Quote
Old 10-08-2013, 11:34 PM   #12
gdpawel
Senior Member
 
gdpawel's Avatar
 
Join Date: Aug 2006
Location: Pennsylvania
Posts: 1,080
Biomarker of Antiangiogenic Therapy

One of the most promising areas of cancer treatment today is also among the most perplexing. A new class of anti-cancer drugs works by interfering with the formation of microvessels which deliver blood to the tumor mass. This starves tumor cells of oxygen and nutrients, interferes with the elimination of cellular wastes, shuts-down routes of tumor metastasis, and potentially aids in the delivery of other types of anti-cancer drugs to the tumor mass.

The problem is that the new drugs – called anti-angiogenesis drugs – work for only a small percentage of patients. Moreover, they can cause serious side effects in some patients and they are extremely expensive – well over $100,000 per year of treatment. Anti-angiogenesis drugs are being used more and more frequently in a widening range of cancer types and so the cost to the healthcare system and to individual patients who must pay for insurance co-payments threatens to be staggering. In fact, several new drugs have now shown anti-angiogenesis activity and these are being combined with standard drugs and with other targeted drugs to produce the maximum therapeutic benefit. The race is on, therefore, to develop tests that can determine which patients could benefit from anti-angiogenesis therapy, which anti-angiogenesis drugs are best for which patients, and which other drugs should be administered concurrently in order to achieve the best result for each patient.

The the AngioRx profile, using microvascular viability assay, invented by Dr. Weisenthal and used exclusively at Weisenthal Cancer Group is the only laboratory test published to date which identifies anti-angiogenic drug activity in live tumor micro-clusters. It is also the only test capable of discriminating anti-tumor effect from anti-angiogenic effect in the same mixed-cell population. It is also the only known technology which discriminates the effects of different types of anti-angiogenic drugs within the same class of drugs and within different classes of drugs. It is also the only known test which is capable of identifying synergistic effects among different angiogenic and non-angiogenic drugs in specific drug combinations.

Bibliography relevant to AngioRx/Microvascular Viability (MVV) assay

1. Weisenthal, L. M. Patel,N., Rueff-Weisenthal, C. (2008). "Cell culture detection of microvascular cell death in clinical specimens of human neoplasms and peripheral blood." J Intern Med 264: 275-287, 2008. doi: 10.1111/j.1365-2796.2008.01955.x

2. Weisenthal, L., Lee,DJ, and Patel,N. (2008). Antivascular activity of lapatinib and bevacizumab in primary microcluster cultures of breast cancer and other human neoplasms. ASCO 2008 Breast Cancer Symposium. Washington, D.C.: Abstract # 166.

3. Weisenthal, L. M. (2010). Antitumor and anti-microvascular effects of sorafenib in fresh human tumor culture in comparison with other putative tyrosine kinase inhibitors. J Clin Oncol 28, 2010 (suppl; abstr e13617)

4. Weisenthal, L., H. Liu, Rueff-Weisenthal, C. (2010). "Death of human tumor endothelial cells in vitro through a probable calcium-associated mechanism induced by bevacizumab and detected via a novel method." Nature Precedings 28 May 2010.

5. Eur J Clin Invest, Volume 37 (suppl. 1):60, 2007

6. Nagourney, R.A. Functional Profiling of Human Tumors in Primary Culture: A Platform for Drug Discovery and Therapy Selection (AACR: Apr 2008-AB-1546)

7. Journal of Clinical Oncology, 2006 ASCO Annual Meeting Proceedings Part I. Vol 24, No. 18S (June 20 Supplement), 2006: 17117

http://www.cancerfocus.org/files/Ava...growth.003.jpg
gdpawel is offline   Reply With Quote
Old 10-08-2013, 11:36 PM   #13
gdpawel
Senior Member
 
gdpawel's Avatar
 
Join Date: Aug 2006
Location: Pennsylvania
Posts: 1,080
Microvascular cell death in clinical specimens of human neoplasms & peripheral blood

Cell culture detection of microvascular cell death in clinical specimens of human neoplasms and peripheral blood.

2008 Sep;264(3):275-87.
Weisenthal LM, Patel N, Rueff-Weisenthal C.
Weisenthal Cancer Group, Huntington Beach, CA 92647, USA. [email]mail@weisenthal.org

BACKGROUND:

Angiogenesis studies are limited by the clinical relevance of laboratory model systems. We developed a new method for measuring dead microvascular (MV) cells in clinical tissue, fluid and blood specimens, and applied this system to make several potentially novel observations relating to cancer pharmacology.

METHODS:

Dead MV cells tend to have a hyperchromatic, refractile quality, further enhanced during the process of staining with Fast Green and counterstaining with either haematoxylin-eosin or Wright-Giemsa. We used this system to quantify the relative degree of direct antitumour versus anti-MV effects of Cisplatin, erlotinib (Tarceva), imatinib (Gleevec), sorafenib (Nexavar), sunitinib (Sutent), gefitinib (Iressa) and bevacizumab (Avastin).

RESULTS:

Bevacizumab (Avastin) had striking anti-MV effects and minimal antitumour effects; Cisplatin had striking antitumour effects and minimal anti-MV effects. The 'nib' drugs had mixed antitumour and anti-MV effects. Anti-MV effects of erlotinib (Tarceva) and gefitinib (Iressa) were equal to those of sunitinib (Sutent) and sorafenib (Nexavar). There was no detectable VEGF in culture medium without cells; tumour cells secreted copious VEGF, reduced to undetectable levels by bevacizumab (Avastin), greatly reduced by cytotoxic levels of cisplatin + anguidine, and variably reduced by DMSO and/or ethanol. We observed anti-MV additivity between bevacizumab (Avastin) and other drugs on an individual patient basis. Peripheral blood specimens had numerous MV cells which were strikingly visualized for quantification with public domain image analysis software using bevacizumab (Avastin) essentially as an imaging reagent.

CONCLUSIONS:

This system could be adapted for simple, inexpensive and sensitive/specific detection of tissue and circulating MV cells in a variety of neoplastic and non-neoplastic conditions, and for drug development and individualized cancer treatment.

Presentation: Antivascular activity of lapatinib and bevacizumab in primary microcluster cultures of breast cancer and other human neoplasms.

http://tinyurl.com/weisenthal-breast-lapatinib
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2008.01955.x/full
gdpawel is offline   Reply With Quote
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is On

Forum Jump


All times are GMT -7. The time now is 10:23 AM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2024, vBulletin Solutions, Inc.
Copyright HER2 Support Group 2007 - 2021
free webpage hit counter