Lisa
06-28-2005, 09:53 PM
As I've mentioned, I e-mailed Dr. Carney at Bayer re: the Her2 serum test. He generously answered me and I think some of you might benefit from his response.
Dr. Carney,
I just watched your presentation of "Clinical Utility of Monitoring Serum Her-2new Oncoprotein Level. It was a wonderful description of Her2 and its role in women with breast cancer. I was left, however, with one big question.
How can this serum test benefit me and women like me?
I had original BC detected in 1999 (at age 41). We knew then that I had positive Her2-neu status. But with no metastasis or positive nodes, of course, Herceptin was not an option. I proceeded with chemo and mastectomy.
Then in Sept. 03, I had metastasis indicated in liver and bones. A FISH test of the liver tumor determined I was Her-2+++. Months of treatment with Navelbine, Herceptin and Zometa shrunk the vast majority of the liver tumor and reduced the bone mets. However, several months later mets were indicated in my brain, for which I had WBR. Following that 21 day treatment, my next scan (in 3 months) showed mets still decreasing in the bone, stabilization in the liver and new mets in the stomach-area lymph nodes. Since Sept. 04, I have been on a regime of Taxol, Herceptin and Zometa.
My last 2 PET scans showed new mets in the liver. The last scan showed stabilization of those mets.
So, my question:
The only benefit I see to taking the serum test would be to tell me whether my disease is truly stable (with less than 15 ng/ml) or if I can expect further destabilization and a shorter life. Since there are currently no treatments other than Herceptin, how could this test benefit me? I have no desire to know if I can expect to die in the upcoming months.
I am active in a web site devoted to educating and supporting Her2+ women. Your response will be shared ( if you permit) with women around the world.
Thank you for taking the time to respond.
Sincerely,
Lisa Lowe
------------------------------------------------------
Hi Lisa. Thank you for your response. The HER-2/neu test is meant to help
oncologists in their management and monitoring of patients with metastatic
breast cancer disease and in particular patients with HER-2 positive breast
cancer. As you know HER-2 positive cancers are known to be aggressive and like estrogen receptors, knowing the HER-2 status can be important. We believe and hope that monitoring the serum HER-2 in the metastatic setting will help avoid FISH type tests having to be done on a liver biopsy. Most likely the alternative to a liver biopsy and FISH test was the serum HER-2/neu test but not having the specifics I can't really comment. I think you will agree, a blood test is far less invasive than a liver biopsy.
Our intent is to have the serum test used to determine if the breast cancer
is responding to or not responding to treatment. As you know, it is important to understand if the breast cancer is progressing, because physicians have many tools available to them to help treat patients. The sooner it can be determined that a breast cancer is progressing the sooner the physician can seek alternative solutions. So instead of thinking that an increasing serum of HER-2/neu is just a bad sign, think of it as information to help physicians do the very best they can for their patients.
The other thing you should know is that most if not all physicians use serum based tests in oncology as one of the many tools to monitor and manage their patients but won't treat patients based on a stable , increasing or decreasing serum HER-2/neu value alone but will use it in conjunction with other clinical information for treatment.
As i said in my earlier email Glaxo SmithKline like many Pharmaceutical
companies are also developing anti-HER-2/neu therapies which will provide
patients and physicians alternatives to Herceptin in the near future.. It is
always positive to have alternatives. We believe that the serum HER-2/neu test will continue to be explored as a Biomarker for patients with HER-2 positive disease in patients with breast cancer and hopefully one day will be widely used to track HER-2/neu positive disease and be used to manage anti-HER-2/neu therapies.
I started HER-2/neu studies in breast cancer in 1986 and although we still have a long way to go, we have come a long way in breast cancer research.
I wish you all the best for your future. It sounds from your description below that you have received excellent care and your team of physicians and nurses are dedicated to doing their best to help you.
I hope this email is informative and also that you understand that as
researchers/scientists and physicians , we still have many challenges in cancer research and that folks like you are part of helping the medical community find better treatments.
Good Luck>>>>>>>>>>>>>>>>>>>>>>>>>>>>>.walt
Dr. Carney,
I just watched your presentation of "Clinical Utility of Monitoring Serum Her-2new Oncoprotein Level. It was a wonderful description of Her2 and its role in women with breast cancer. I was left, however, with one big question.
How can this serum test benefit me and women like me?
I had original BC detected in 1999 (at age 41). We knew then that I had positive Her2-neu status. But with no metastasis or positive nodes, of course, Herceptin was not an option. I proceeded with chemo and mastectomy.
Then in Sept. 03, I had metastasis indicated in liver and bones. A FISH test of the liver tumor determined I was Her-2+++. Months of treatment with Navelbine, Herceptin and Zometa shrunk the vast majority of the liver tumor and reduced the bone mets. However, several months later mets were indicated in my brain, for which I had WBR. Following that 21 day treatment, my next scan (in 3 months) showed mets still decreasing in the bone, stabilization in the liver and new mets in the stomach-area lymph nodes. Since Sept. 04, I have been on a regime of Taxol, Herceptin and Zometa.
My last 2 PET scans showed new mets in the liver. The last scan showed stabilization of those mets.
So, my question:
The only benefit I see to taking the serum test would be to tell me whether my disease is truly stable (with less than 15 ng/ml) or if I can expect further destabilization and a shorter life. Since there are currently no treatments other than Herceptin, how could this test benefit me? I have no desire to know if I can expect to die in the upcoming months.
I am active in a web site devoted to educating and supporting Her2+ women. Your response will be shared ( if you permit) with women around the world.
Thank you for taking the time to respond.
Sincerely,
Lisa Lowe
------------------------------------------------------
Hi Lisa. Thank you for your response. The HER-2/neu test is meant to help
oncologists in their management and monitoring of patients with metastatic
breast cancer disease and in particular patients with HER-2 positive breast
cancer. As you know HER-2 positive cancers are known to be aggressive and like estrogen receptors, knowing the HER-2 status can be important. We believe and hope that monitoring the serum HER-2 in the metastatic setting will help avoid FISH type tests having to be done on a liver biopsy. Most likely the alternative to a liver biopsy and FISH test was the serum HER-2/neu test but not having the specifics I can't really comment. I think you will agree, a blood test is far less invasive than a liver biopsy.
Our intent is to have the serum test used to determine if the breast cancer
is responding to or not responding to treatment. As you know, it is important to understand if the breast cancer is progressing, because physicians have many tools available to them to help treat patients. The sooner it can be determined that a breast cancer is progressing the sooner the physician can seek alternative solutions. So instead of thinking that an increasing serum of HER-2/neu is just a bad sign, think of it as information to help physicians do the very best they can for their patients.
The other thing you should know is that most if not all physicians use serum based tests in oncology as one of the many tools to monitor and manage their patients but won't treat patients based on a stable , increasing or decreasing serum HER-2/neu value alone but will use it in conjunction with other clinical information for treatment.
As i said in my earlier email Glaxo SmithKline like many Pharmaceutical
companies are also developing anti-HER-2/neu therapies which will provide
patients and physicians alternatives to Herceptin in the near future.. It is
always positive to have alternatives. We believe that the serum HER-2/neu test will continue to be explored as a Biomarker for patients with HER-2 positive disease in patients with breast cancer and hopefully one day will be widely used to track HER-2/neu positive disease and be used to manage anti-HER-2/neu therapies.
I started HER-2/neu studies in breast cancer in 1986 and although we still have a long way to go, we have come a long way in breast cancer research.
I wish you all the best for your future. It sounds from your description below that you have received excellent care and your team of physicians and nurses are dedicated to doing their best to help you.
I hope this email is informative and also that you understand that as
researchers/scientists and physicians , we still have many challenges in cancer research and that folks like you are part of helping the medical community find better treatments.
Good Luck>>>>>>>>>>>>>>>>>>>>>>>>>>>>>.walt