Herceptin for only 3 months?

[2KidMom]

Hi everyone - I am new to the site and I tried to see if this had been discussed but did not find anything....my onc is considering stopping my Herceptin treatment at 3 months based on the Finland study. I just had my mast and the pathology showed that the chemo wiped out some other suspicious areas that showed up on the MRI after my lumpectomy so he feels confident that if there were any other cells floating around the chemo got them. My MUGA results have been fine so he says he doesn't want to cause any damage or give me more treatment than what is necessary.....I would be totally fine with his decision EXCEPT that I still worry about my Oncotype score coming back 80....

Please let me know if any of your oncs have suggested only 3 months of treatment for early stage...thanks in advance! Jan

[Becky]

You are young and stopping Herceptin at 3 months is not proven nor is the FinHer trial. Standard of care in the USA, Europe and Australia is one full year. There is a trial that will test if 6 months is as good as a year. In my opinion it will be but until then, one year is standard. Discuss this fact with your oncologist. They seem to love trials in general and there are 8 worldwide on one year of Herceptin and only one trial (FinHer) on 9 weeks (with a very,very small trial population).

[2KidMom]

Thanks Becky...I am sure we will have lots to discuss at my next appt...I have been doing my research!!

[Lani]

also used an entirely different set of chemotherapy drugs

Drs. Slamon and Piccart are reexamining the results of the North American and HERA adjuvant herceptin clinical trials focusing on those patients who had to stop herceptin early due to decreases in LVEF (heart function) in order to see if that data can be utilized to determine if those having shorter courses did just as well or not . At AACR I learned that the investigation is ongoing, hopefully with results soon.


It is generally accepted that it is considered immoral to have trials where they give patients less than the treatment they know to be beneficial--which one year of herceptin truly is-- (which is why trials normally are designed to give the standard of care treatment PLUS something they think might make it even better)

[sdhaem]

I was taken off herceptin after 18 treatments. i do worry but it did heart damage... I keep hoping that I had enough to keep cancer from coming back

[RobinP]

Hi there,

I wish researchers had gone back sooner and done more studies to see if less Herceptin is better. The Finnish study certainly does point to that. Anyway, at least Dr. Piccart and Dr. Salmon are going to have their results back soon...you may want to check into that and contact these people.

I did 9 weeks of Herceptin late as that was the only thing recommended to me, not the year due to doing late Herceptin. Well, I'm still alive six years out. I had a similar dx. with 4mm of her2+ invasive and 5cm of DCIS, ERPR-, but I had a positive sentinel node for micromets. No, the standard of care is not 9 weeks, as the studies were not large enough in the Finnish study to convince the oncology society that their results were better than the larger one year studies. Did the Finnish study have statistical significance? Yes, as the study included more than 120 patients. And I might add that their results were as effective as one year of Herceptin. There is higher cardiac risk with Herceptin for one year as opposed to 9 weeks and that may just help you make a choice of what to do. If you think about it, that is probably why your physician is recommending less Herceptin because of the cost benefit ratio, where you MAY have less of a relapse risk due to the small size of your invasive, particularly if it is truly ERPR+, which has less relapse risk than ERPR-.Good luck in your decision. Get many second opinions, do your homework, and go with what your heart tells you to do.

PS. I might also add to follow some of the her2 diet recommendations that RB has posted to help prevent a relapse. Every little bit helps.

Smile,
Robin

PS. Take a look at the HERA study to see what your relapse risk is for such a small her2+ invasive.

[2KidMom]

Well, the debate is over for me...my MUGA actually improved this week so he says we will stay with the standard of 12 months....I'm relieved!!

[Jackie07]

That's great! Thanks for sharing your relieve.

[Ursula]

Hello everybody!

This is the thread that originally made me to join into this group. I wanted to share my experience and knowledge about this nine weeks treatment.

In Finland there are more than 4000 women who become diagnosed having breast cancer. One fifth of them is HER2-positive and receive Herceptin as their first line treatment. Encouraged by the FinHer study most Finnish cancer clinics have approved nine weeks treatment as their standard protocol. The results have been good and the mortality rates keep on diminishing. It is truly encouraging to me that I really know no-one whose disease has relapsed after nine weeks of Herceptin! The statistics tell about the same because overall survival rates of HER2-positive were nearly 90 % in the five year follow up of FinHer.

Naturally there are still Finnish oncologists who believe in the one year treatment. Only future and international research can tell which treatment is the best. At least we have found a very cost effective way to treat this serious disease.

[RobinP]

Ursula, thanks for chiming in on this topic and sharing your Finnland results, which are so encouraging! Herceptin is certainly a wonder drug with powerful results, even proving itself in a short course!

[westswon]

Hi there. I too am stopping Herceptin at 21 weeks--ONC feels that the side effects are too present and that the Finnish study was a good one. Ursula's feedback helps me with this decision. My tumor was less than 1 cm... just finished radiation... so, onward and upward in healing from it all... westswon