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Old 04-15-2009, 08:27 AM   #1
Lani
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Join Date: Mar 2006
Posts: 4,778
only were her2 2+? not to worry, no evidence herceptin works any less well for you!

J Clin Oncol. 2009 Apr 13. [Epub ahead of print]

Disease-Free Survival According to Degree of HER2 Amplification for Patients Treated With Adjuvant Chemotherapy With or Without 1 Year of Trastuzumab: The HERA Trial.

Dowsett M, Procter M, McCaskill-Stevens W, de Azambuja E, Dafni U, Rueschoff J, Jordan B, Dolci S, Abramovitz M, Stoss O, Viale G, Gelber RD, Piccart-Gebhart M, Leyland-Jones B.
Department of Academic Biochemistry, Royal Marsden Hospital, London, United Kingdom; Frontier Science (Scotland) Ltd, Kincraig, Kingussie, Scotland; National Cancer Institute, National Institutes of Health, Bethesda, MD; Departments of Medical Oncology and Medicine, Institut Jules Bordet, Université Libre de Bruxelles; Breast European Adjuvant Studies Team, Brussels, Belgium; Department of Public Health, School of Nursing, University of Athens, Athens, Greece; TARGOS Molecular Pathology GmbH, Kassel, Germany; Roche Professional Diagnostics, F. Hoffmann-La Roche Ltd, Basel, Switzerland; VM Institute of Research, Montreal, Quebec, Canada; Division of Pathology and Laboratory Medicine, European Institute of Oncology and University of Milan, Milan, Italy; Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA; and Emory Winship Cancer Institute, Atlanta, GA.
PURPOSE: To determine whether (1) immunohistochemical (IHC) HER2 status (ie, 2+ or 3+), (2) degree of fluorescence in situ hybridization (FISH) amplification according to (2a) HER2/CEP17 ratio or (2b) HER2 gene copy number, or (3) polysomy significantly influenced clinical outcome for patients with human epidermal growth factor receptor 2 (HER2) -positive breast cancer enrolled in the Herceptin Adjuvant trial of trastuzumab versus no trastuzumab administered after completion of chemotherapy. PATIENTS AND METHODS: IHC and/or FISH analyses were performed locally and required central confirmation as indicating HER2 positivity for trial entry. FISH data from the central HER2 analysis on patients in the 1-year trastuzumab and no trastuzumab arms were assessed in relation to disease-free survival (DFS) after a median 2 years of follow-up. RESULTS: Central FISH results were available for 2071 (61%) of the 3,401 patients randomized to the 2 arms. Among patients with FISH-positive disease, (1) the hazard ratios for trastuzumab versus no trastuzumab were 0.56 (95% CI, 0.32 to 0.99) for locally IHC2+ cases (n = 340) and 0.80 (95% CI, 0.40 to 1.61) for centrally IHC2+ cases (n = 299). There was no significant prognostic relationship between (2a) HER2 FISH ratio, (2b) HER2 copy number, or (3) polysomy and DFS in the control arm or predictive relationship defining differential benefit from trastuzumab. CONCLUSION: There was no evidence for reduced benefit of trastuzumab in HER2 IHC2+FISH+ cases. The degree of HER2 amplification does not influence prognosis or benefit from adjuvant trastuzumab in patients treated with prior adjuvant chemotherapy.
PMID: 19364966
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Old 04-15-2009, 12:07 PM   #2
Rich66
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Location: South East Wisconsin
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Interesting. Seems different than previous studies. I hope it holds true for mets.
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