efficacy of Herceptin - to Marcy

Marcy,

That is just one study & I'm not sure it meant much of anything. Perhaps part of the confusion is the Her2+ status and what it means. You may remember reading some people who are Her2+, Her2++, Her2+++, and so on. I read a recent definition of Her2 positive status is a person who tests out as a 3. One who tests out at a 2 is somewhat of an overexpressor of the Her2 oncogene, while 1 is not considered an overexpressor. With that in mind, it has been determined that Herceptin works best on people who test out at Her2+++ (which by the definition above are true Her2+ people). That may be where the 30% rate comes in to play, because they have found by giving Herceptin to those who are Her2+ & Her2++ generally does not work. This study suggests that at some time Herceptin no longer works and it is not because it no longer binds around the cells. Unfortunately I could only read the brief abstract so it offered little insight to how the study was conducted and so on. I think people are looking at two different issues: Whether it works to begin with; and how long can one be on it before it is no longer effective. I'm not sure there is enough evidence out there on this. I do know most oncologists hesitate to use Herceptin in the early stage of bc due to this very reason. No one wants to take the chance of it not working when you really need it to. Chemo does seem to work better when combined with Herceptin - is it the chemo or the Herceptin (I think the Herceptin). Anyhow, I think it's reasonable to be on maintenance Herceptin for a time mutually agreeable to the onc and patient. Remember Barbara Bradfield - she has never received maintenance Herceptin yet remains NED after all these years and she was Stage IV when she received Herceptin & chemo. I guess I am just trying to say don't worry about one study....I guess it is possible that cells can mutate themselves after a period of time - just like they do with antibiotics - so that they may become resistant to Herceptin with very long term use. Other things are in the pipeline so it's just not worth worrying too much about. Hope this helps you.
Kitty