Herceptin results from the two key North American trials revisited--benefit holds up

[Lani]

long-term (median time on trial 8.4 years) and in all groups

http://jco.ascopubs.org/content/32/33/3744

[tricia keegan]

Good news, thanks Lani.

[caya]

Thanks for posting this, Lani.

I am just over 8 years out, NED.

all the best
caya

[suzan w]

Great news!!

[rhondalea]

Am I missing something?

Did they really withhold Herceptin from the control group as late as 2012? Really?

Edited to add: Okay, never mind. I understand what they did. The way I read it the first time, though, I wanted to strangle them.

['lizbeth]

Somehow I am not as excited about a DFS of 73% and overall survival as 84%.

As grateful as I am to have received Herceptin, I'm really, really glad for Tykerb, Perjeta and Kadcyla too.

This is why I get so excited about the numbers on the vaccine trials. Those look even better to me.

Herceptin got the ball rolling on our Her2 research. If the folks hadn't gotten behind this treatment and advanced it to the market many more of us would be posting about recurrence and looking for 'magic unicorns'.

I am really looking forward to how our numbers improve over the next couple decades.

We've come a long way baby!

[Becky]

Remember the Herceptin trials first began using node positive women only and then migrated to node negative IF the tumor was over 1 cm. With Her2, survival was improved 33% to 52% . That correlates to someone like me of alittle less than 70% BEFORE Herceptin. And these results are bundling the stage 1 women with the stage 3c women. So, quite remarkable in my view and that the stats hold gives some reassurance that if you are okay down the road, you just may stay that way.

I am 10 years out and had to fight for Herceptin and got it alone after chemo and rads were over. I amgrateful and 10+ years out. It could have beeb my game changer and has been for many. The new drugs do enhance Herceptin but cannot replace it.

[RobinP]

Yeah, Ned for a decade and some......!

['lizbeth]

Nope Becky, because of folks like you, the Druthers, and many others I don't remember that.

In just 3 years standard of care advanced enough that I could receive Herceptin as Stage II in late 2007. How different my experience was. It felt as scary because the numbers for my stage were based on pre-Herceptin information. The numbers for Her2+ with Pagets were grim. Herceptin changed all that.

I disagree with your current view of Herceptin. It is still to be determined exactly who it helps and who it doesn't. Patients are forced to receive it due to standard of care, even if they don't benefit. And others were left out for over a decade when Herceptin could have been the game changer for them.

If we advance technology to determine better who and when patients benefit from each Targeted treatment, Herceptin, Perjeta, Kadcyla, Tykerb, etc the numbers will become better - and we will be living longer with a much greater quality of life.

Yes, Herceptin changed the game. But, the game needs changing even more.

[Becky]

I think that Herceptin helps most Her2+ women however, some women have another devil involved besides ER or PR. They may be insulin receptor positive or Her1+(aka EGFR) or something else so they need something to block that. Some women have truncated Her2 receptor so Herceptin doesn't attach to it right so it doesn't work. However, I think the Herceptin is still needed. It works but the woman has more than one "GO" button on the cancer. There is still much to learn and Herceptin and Her2 in general is just one piece of the puzzle. For some of us, ER and PR are also part of the puzzle. Once the puzzle pieces are identified, everyone will benefit. Even women who are only ER and PR positive do not all do well even though there are many hormonal treatments for this. Research is needed and ongoing. Hopefully they find more receptors for multiple targets so the chemo poisons can be stopped and treatment will be effective but there will be a better quality of life thru it.

['lizbeth]

Love that response.

I just don't want Genentech, or anyone else to get complacent about cancer treatments.
Yes, Herceptin was a blockbuster. BUT, not just more research - a little creative thinking outside the box could have gone a long way. The industry held on to the blockbuster status way too long, when they should have been looking for ways outside of the 1 year adjuvant treatment to best use Herceptin.

I agree with what you posted. I disagree with the current system of large scale clinical trials that take years to finish. In order to achieve what you pointed out the system must be changed. The number of study participants will have to shrink. Testing needs to improve and the science behind this.

My biggest unhappiness with our current system is that Overall Survival is an acceptable endpoint. Ah, we are trying to save lives here. What kind of society allows patients to die to get a treatment approved at FDA. This is madness.

Define a new endpoint prior to death. No patient should die so that you and I can get a treatment as part of standard of care. How did this become an "acceptable insanity"?

Design a system that gives these patients many more opportunities for clinical trials at stage IV or metastatic disease. The Right to Try is the first step in the right direction. Let's run in that direction and redefine how we handle patients who are in the greatest need of a miracle.

Yes, I am impatient. I am tired of seeing progression and suffering. Thankfully it seems that a large number are being helped considerably with the new TCHP.

I do appreciate Genentech, and all others who work so hard to keep us well.

However, its not enough - keep going forward finding and improving treatments. Finding and improving testing. And each time I hear someone being complacent about HER2 cancer my little voice is going to pop up and push for progress.