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Old 07-16-2011, 10:53 AM   #1
Lani
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not new news but worth repeating>90% of her2+ bc potentially curable just with H,T, P

H=herceptin
T=Tykerb
P=pertuzumab, which is expected to seek FDA approval later this year!

Certain Drug Combinations May Beat Back Aggressive Breast Cancer


FRIDAY, Dec. 10 (HealthDay News) -- Combinations of targeted therapies for an especially aggressive type of breast cancer could potentially usher the majority of affected patients into remission, researchers at a major breast cancer meeting said Friday.
Presenting results from three trials at the annual San Antonio Breast Cancer Symposium, scientists explained that administering two or more drugs designed to treat HER2-positive tumors resulted in much higher remission rates than doses of any one drug or standard chemotherapy alone.
Given to patients several weeks before cancer surgery, with or without chemotherapy, the medications often shrank tumors dramatically or eradicated them altogether, the researchers said.
HER2-positive cancer is receptive to a protein called human epidermal growth factor receptor 2, which promotes the growth of malignant cells. Drugs that specifically target HER2 cells -- including Herceptin, Tykerb and pertuzumab -- have been proven effective on these types of tumors, which tend to be more aggressive than other breast cancers.
"I think it's a very exciting era, because we've gone from a very lethal era . . . to a point where we might be able to cure this disease," said Dr. Neil Spector, a professor of medicine at Duke University Medical Center, who moderated the symposium session.
Using Tykerb and Herceptin combined with chemotherapy before surgery, researchers followed 2,500 women with early breast cancer at 85 facilities throughout Germany. About half of these patients achieved remission before surgery, said Dr. Michael Untch, head of the multidisciplinary breast cancer department at Helios Clinic in Berlin.
"In a majority of these patients, we could do breast-conserving surgery where previously they were candidates for mastectomy," Untch said.
The team will continue following the patients to see if remission at surgery affects their outcome.
Another study showed the combination of pertuzumab and Herceptin, when given with the chemotherapy drug docetaxel, eradicated 46 percent of tumors, 50 percent more than the results achieved without pertuzumab. Also, 17 percent of tumors were eradicated by combining the two targeted drugs and skipping chemotherapy, the researchers said.
"Our study is the only one that has tested the hypothesis that [pertuzumab and Herceptin] could work without chemotherapy in these women," said lead researcher Dr. Luca Gianni, director of medical oncology at the Fondazione IRCCS Istituto Nationale Tumori Fondazione IRCCS Istituto di Milano in Italy.
The third study, which included 455 patients followed at 99 sites for nearly two years, indicated that a combination of Tykerb, Herceptin and the chemotherapy drug Taxol improved tumor response rates significantly more than any of the drugs alone.
The mix led to a 51 percent remission rate, compared to 29 percent for a single therapy, said lead researcher Dr. Jose Baselga, chief of the division of hematology and oncology and associate director of the Massachusetts General Hospital Cancer Center.
"With these new therapies, we could easily go to curing over 90 percent of these patients, which is remarkable since this was the most lethal kind of breast cancer 10 years ago," said Baselga.
"This is a very fast advancement of new therapies," Untch agreed.
Researchers countered negative side effects of the drugs, which included diarrhea, liver function abnormalities, skin disorders and a low white blood cell count, by lowering patients' dosages or administering additional medications to alleviate specific symptoms.
Describing targeted therapies as a "HER2 blockade," Spector said if cost was not an issue, he would use all three drugs on HER2-positive breast cancer patients.
Discussing the high cost of treatment at the session, the researchers noted that spending more money on faster-acting, more effective treatments could save other treatment expenditures down the line.
"I do think we need to be creative in the ways we [run through] this data to make things more affordable," Spector said.
Because this study was presented at a medical meeting, the findings should be viewed as preliminary until they are published in a peer-reviewed journal.
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Old 07-16-2011, 12:42 PM   #2
tricia keegan
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

Exciting news Lani and thanks for posting!
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Old 07-16-2011, 02:52 PM   #3
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

Lani,

I had never seen this article. I so appreciate you posting this. Sometimes in this cancer fight things have seemed pretty desperate, but it is amazing to be living with this disease and see such hopeful drugs coming down the pike right now. I just pray they hurry and get these drugs avaliable very soooon! So close, yet so far away!!!

Joyce
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Old 07-17-2011, 04:47 AM   #4
Ellie F
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

Lani, thanks again for your diligence. I also had not seen this post so glad you posted.
Like Joyce let's hope it's available soon and the money issue doesn't stop us getting what's needed!
Ellie
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Old 07-17-2011, 08:01 AM   #5
sarah
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

great! thanks Lani.
health and happiness
love sarah
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Old 07-17-2011, 03:30 PM   #6
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

Lani,
I am sure glad you did repeat this news again, because it seems as so many of us missed this before. It's very encouraging news. The type we like hearing.

Chelee
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DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
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10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
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Old 07-22-2011, 06:41 AM   #7
'lizbeth
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

Well, maybe not new to you Lani, but somehow I missed it!

So glad to see this. In fact, it feels to me like there is a lot more progress in the science of cancer in just the last year.

I feel highly encouraged!
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Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
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Old 07-22-2011, 05:53 PM   #8
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

Lani,

Is there any data to show how the trio of drugs might affect outcomes for already treated Stage IV patients?

Thanks
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Old 07-22-2011, 05:56 PM   #9
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

A similar article on the exciting news:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3113372/
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http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

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hptc hemangioma
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Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016

"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe

Last edited by Jackie07; 07-22-2011 at 05:59 PM..
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Old 07-22-2011, 06:23 PM   #10
Jackie07
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

Nancy,

Looks like T-DM1 is the answer for heavily pre-treated patients:

J Clin Oncol. 2011 Feb 1;29(4):398-405. Epub 2010 Dec 20.
Phase II study of the antibody drug conjugate trastuzumab-DM1 for the treatment of human epidermal growth factor receptor 2 (HER2)-positive breast cancer after prior HER2-directed therapy.

Burris HA 3rd, Rugo HS, Vukelja SJ, Vogel CL, Borson RA, Limentani S, Tan-Chiu E, Krop IE, Michaelson RA, Girish S, Amler L, Zheng M, Chu YW, Klencke B, O'Shaughnessy JA.
Source

Sarah Cannon Research Institute, Nashville, TN 37203-1632, USA. howard.burris@scresearch.net

Abstract

PURPOSE:

The antibody-drug conjugate trastuzumab-DM1 (T-DM1) combines the biologic activity of trastuzumab with targeted delivery of a potent antimicrotubule agent, DM1, to human epidermal growth factor receptor 2 (HER2)-overexpressing cancer cells. Based on results from a phase I study that showed T-DM1 was well tolerated at the maximum-tolerated dose of 3.6 mg/kg every 3 weeks, with evidence of efficacy, in patients with HER2-positive metastatic breast cancer (MBC) who were previously treated with trastuzumab, we conducted a phase II study to further define the safety and efficacy of T-DM1 in this patient population.
PATIENTS AND METHODS:

This report describes a single-arm phase II study (TDM4258g) that assessed efficacy and safety of intravenous T-DM1 (3.6 mg/kg every 3 weeks) in patients with HER2-positive MBC who had tumor progression after prior treatment with HER2-directed therapy and who had received prior chemotherapy.
RESULTS:

With a follow-up of ≥ 12 months among 112 treated patients, the objective response rate by independent assessment was 25.9% (95% CI, 18.4% to 34.4%). Median duration of response was not reached as a result of insufficient events (lower limit of 95% CI, 6.2 months), and median progression-free survival time was 4.6 months (95% CI, 3.9 to 8.6 months). The response rates were higher among patients with confirmed HER2-positive tumors (immunohistochemistry 3+ or fluorescent in situ hybridization positive) by retrospective central testing (n = 74). Higher response rates were also observed in patients whose tumors expressed ≥ median HER2 levels by quantitative reverse transcriptase polymerase chain reaction for HER2 expression, compared with patients who had less than median HER2 levels. T-DM1 was well tolerated with no dose-limiting cardiotoxicity. Most adverse events (AEs) were grade 1 or 2; the most frequent grade ≥ 3 AEs were hypokalemia (8.9%), thrombocytopenia (8.0%), and fatigue (4.5%).
CONCLUSION:

T-DM1 has robust single-agent activity in patients with heavily pretreated, HER2-positive MBC and is well tolerated at the recommended phase II dose.
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http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016

"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe
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Old 07-23-2011, 03:30 AM   #11
Paula O
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

I, too, want to express my appreciation to Lani, Jackie, and others in the group posting abstracts and results of research. Thanks a lot. It certainly is a help.

Paula
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Old 07-24-2011, 06:51 AM   #12
pibikay
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

Lani you are always there with some +ve news.Thanks
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Metstatic Breast Cancer Stage 4
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ossousmetstatis in vertbrae secondaries L4=L5secondary
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Herceptin started again on 27th Dec 2012.Xeloda stopped Navelbin added on 7th February 2013.Now on Tykerb Herceptin and Navelbin
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Old 07-24-2011, 02:54 PM   #13
Lani
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Re: not new news but worth repeating>90% of her2+ bc potentially curable just with H,

You are most welcome!
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