Recurrence rate reduction w/Sequential Herceptin

[Becky]

I just started Herceptin last Friday (because I was lucky enough to only be 4 months out of chemo and can take advantage of the trial results). I had a hard time finding results of recurrence rate reductions when taking Herceptin sequentially versus concurrently with taxol (I had dense dose chemo with 4 rounds of A/C followed by 4 rounds of taxol every 2 weeks with Leukine as my WBC booster).

The info I found states that concurrently with taxol with Herceptin out one year has a recurrence rate reduction of 52% (I think that's well known). However, I found that Herceptin sequentially (after taxol) reduces recurrence rate by only 13% versus taxol as the last treatment (using Herceptin for 52 weeks). This seems so low - to a point that out of 100 HER 2 positive women, it is only increasing the benefit by 4% (which happens to be about the same rate as congestive heart failure). I am going to continue because in my heart I feel it MUST be better than that!!

Does anyone have any other figures?

Thank you in advance

Becky

[Merridith]

Hi Becky:

You have the latest available information.

As you know, the info from the HERA trial has just been published in advance of completion of the trial. The statistical outcome of "what if" of various scenarios are completely unknown at this point.

By electing to take herceptin sequentially at this point you going to help create the ground-breaking stats that the women coming behind you can use to answer the very questions that you are asking.

I also will be taking the herceptin sequentially, but even further out... nearly 2 years. The costs and benefits of doing so are completely unkown. You have to give it your best guess and hope for the best.

Regards,
Merridith

[michele u]

Becky,
both me and Audrey from this board took Herceptin after Taxol for a year. I had 34 pos nodes and Audrey had around 10. She is 4 years out and i'm 2 with no recurrence. she that should give you alittle encouragment.

[jojo]

Becky, I do not think that we will get this kind of stats for a good number of years, as this probably is the first year of Herceptin treatment in the early-stage setting...

[*_Christine MH_*]

Having spent way too much time looking at the trial results, it seems like the 46% reduction in risk from sequential herceptin on the HERA trial came about because many women on the trial only received an anthracycline. My oncologist DID point out to me that HERA was not designed to explore anthracycline vs. anthracycline + taxane for HER2, but there was a study presented at ASCO which showed that six rounds of the anthracycline FEC resulted in a poor prognosis for HER2+, whereas 3 FECs followed by 3 taxoteres did not, so I think I am on to something. Anyway, HERA's risk reduction after just getting an anthracycline was something like 57%. The risk reduction after anthracycline + taxane combo was about 23%. Risk reductions are just estimates and I think the HERA trial result suggests that the benefit may be higher than 13%.

However, the risk of congestive heart failure on HERA was very low, just .5%. Herceptin only caused problems when it was given with adriamycin.

You also need to keep in mind any risk factors you might have that might make you higher risk. I didn't respond well to pre-surgery chemo and was diagnosed within six months of having a baby, which are both bad risk factors.

Personally, I think that it is worthwhile because even if it only saves 4% because I want to do everything I can to prevent a recurrence.

Best wishes,

Christine

[dberg]

The "not knowing" aspect of herceptin doesn't bother me at all. I had 15 weeks of AC, followed by 12 weeks of Taxol. When you really think about it, nobody '"knows" if that regimen will work for me either.

What I DO KNOW is that herceptin is designed specifically for what I have. Three months out of chemo may not be the best time to start it , but we won't know unless we try, right?

[*_Scott_*]

I have been using a site that Johns Hopkins recommends. I'm not sure if anyone has mentioned this site before.adjuvant! (http://adjuvantonline.com/online.jsp)

This gives a good graphical representation of the benefits of the different treatment scenarios with Herceptin from the trials. Another option on the site is to enter your tumor size, hormonal and nodal status and get recurrence rates and treatment benefits with various regimens. The statistics are a little sobering but very informative. The site is intended for medical professionals so you need to enter some bogus information to register.

[christine from Oz]

so Christine MH, are you teling me that my 8 doses off FEC were not as useful as the other chemos? i have always wondered if i got the right stuff as my onco didn't know my HER-2 status. I will still keep my fingers crossed.

[Christine MH]

Hi Christine from Oz,

The 3 * FEC -> 3 * taxotere combination was clearly better for HER-2, but I have never seen anything on 8 * FEC.

Is there any chance of you getting herceptin? I am paying for it in the UK, since I have a poor prognosis (don't know the exact figure, but my oncologist should never play poker).