paper on whether it is safe/smart to give herceptin concurrently with whole brain rad

[Lani]

iation therapy

Int J Radiat Oncol Biol Phys. 2010 Oct 5. [Epub ahead of print]
Preliminary Results of Whole Brain Radiotherapy with Concurrent Trastuzumab for Treatment of Brain Metastases in Breast Cancer Patients.
Chargari C, Idrissi HR, Pierga JY, Bollet MA, Diéras V, Campana F, Cottu P, Fourquet A, Kirova YM.

Department of Radiation Oncology, Institut Curie, Paris, France.
Abstract
PURPOSE: To assess the use of trastuzumab concurrently with whole brain radiotherapy (WBRT) for patients with brain metastases from human epidermal growth factor receptor-2-positive breast cancer.

METHODS AND MATERIALS: Between April 2001 and April 2007, 31 patients with brain metastases from human epidermal growth factor receptor-2-positive breast cancer were referred for WBRT with concurrent trastuzumab. At brain progression, the median age was 55 years (range, 38-73), and all patients had a performance status of 0-2. The patients received trastuzumab 2 mg/kg weekly (n = 17) or 6 mg/kg repeated every 21 days (n = 14). In 26 patients, concurrent WBRT delivered 30 Gy in 10 daily fractions. In 6 patients, other fractionations were chosen because of either poor performance status or patient convenience.

RESULTS: After WBRT, radiologic responses were observed in 23 patients (74.2%), including 6 (19.4%) with a complete radiologic response and 17 (54.8%) with a partial radiologic response. Clinical responses were observed in 27 patients (87.1%). The median survival time from the start of WBRT was 18 months (range, 2-65). The median interval to brain progression was 10.5 months (range, 2-27). No Grade 2 or greater acute toxicity was observed.

CONCLUSION: The low toxicity of trastuzumab concurrently with WBRT should probably not justify delays. Although promising, these preliminary data warrant additional validation of trastuzumab as a potential radiosensitizer for WBRT in brain metastases from breast cancer in the setting of a clinical trial.

PMID: 20932686

[Rich66]

Sounds good..anything that boosts the benefit. Has Herceptin typically been stopped during rads?
It seems like the old hypothesis that therapies interfere with rads keeps turning up false....sometimes missing opportunity for synergy.

J Cancer Res Clin Oncol. 2010 Sep 22. [Epub ahead of print]
Radioembolization and systemic chemotherapy improves response and survival for unresectable colorectal liver metastases.
Chua TC, Bester L, Saxena A, Morris DL.
Hepatobiliary and Surgical Oncology Unit, Department of Surgery, University of New South Wales, St. George Hospital, Sydney, NSW, Australia.



Abstract
PURPOSE: To evaluate the role of radioembolization and systemic chemotherapy as a combined modality therapy for unresectable colorectal liver metastases.
PATIENTS AND METHODS: Prospective database of a major yttrium-90 microsphere radioembolization treatment center in Sydney, Australia, that included 140 patients with unresectable colorectal liver metastases was analyzed. Tumor response, overall survival, treatment-related complications and an evaluation of its role as a combined modality therapy with systemic chemotherapy were performed.
RESULTS: One hundred and thirty-three patients (95%) had a single treatment, and seven patients (5%) had repeated treatments. Response following treatment was complete in two patients (1%), partial in 43 patients (31%), stable in 44 patients (31%), and 51 patients (37%) developed progressive disease. Combining chemotherapy with radioembolization was associated with a favorable treatment response (P = 0.007). The median overall survival was 9 (95% CI 6.4-11.3) months with a 1-, 2-, and 3-year survival rate of 42, 22, and 20%, respectively. Primary tumor site (P = 0.019), presence of extrahepatic disease (P = 0.033), and a favorable treatment response (P < 0.001) were identified as independent predictors for survival.
CONCLUSION: Combined modality therapy appears to improve tumor response rates. Survival is influenced by tumor site, presence of extrahepatic disease, and response to therapy. Yttrium-90 microsphere radioembolization is safe and may best be combined with systemic chemotherapy for patients with unresectable colorectal liver metastases.

PMID: 20859640 [PubMed - as supplied by publisher]