Herceptin question?

[Rhonda4]

I know this has been discussed before, but when going back over the replies, I am finding different answers and would like some clarification. In the recent Herceptin trials what was the reduction in recurrance % when taking Herceptin WITH chemo vs. the reduction in recurrance % when taking Herceptin AFTER chemo and where did you get this info (an attachment would be appreciated). I'm a "factual" person and like details. Thank you.

[*_Christine MH_*]

Hi Rhonda,

This somewhat depends on the trial. In the U.S. trials, herceptin after three weekly AC->taxol reduced recurrence by 13% over AC->taxol whereas adding herceptin to the taxol part slightly more than halved recurrence over AC->taxol. There were hardly any node-negative women in these trials.

In the international HERA trial, however, herceptin given after chemotherapy showed a dramatic 46% difference in recurrence. HERA was did not include a herceptin-based chemo arm, just a two year's of herceptin arm that has yet to report out (November maybe?).

Potential reasons for the difference between the two trials:

1. Most of the women in the HERA trial just got an anthracycline. For the women who got a taxane in the HERA trial, the reduction in risk of recurrence was 23%, whereas for women who just got an anthracycline, it was much, much larger (I think 67% maybe). So, looking at the two studies it could be that the true benefit of herceptin after an anthracycline + taxane combo would be somewhere between 13% and 23%.

2. One third of the women on the HERA trial were node-negative.

It should be noted that concurrent herceptin seems to be slightly harder on the heart than sequential herceptin, but not by much. However, an article in the NCI Bulletin said: "Importantly, after 6 months of
terminating or completing trastuzumab therapy, a substantial
proportion of these women were safely taken off their cardiac medicine,
indicating that the toxicity may be reversible.
Experts cautioned that long-term follow-up data will need to be collected to really know what this risk is.

Personally, if I had just been diagnosed, I would go for herceptin-based chemo if I could get it.

[Rhonda4]

Christine MH,

Thank you. Your post was interesting as NEITHER would apply to me so, I guess this is another reason why it is hard to make comparissons. Also, I am a firm believer that the persons age, general health, stress level, positive/ negative attitude, stongly vs. weakly Her2, faith, diet and exercise etc. ALL play a factor in their recovery/risk of recurrence.

". In the U.S. trials, herceptin after three weekly AC->taxol reduced recurrence by 13% over AC->taxol whereas adding herceptin to the taxol part slightly more than halved recurrence over AC->taxol. There were hardly any node-negative women in these trials." ***I had 6 dose dense TEC and am node negative (my doctor originally had not planned to give me Herceptin, but must have changed his mind after the news***

"1. Most of the women in the HERA trial just got an anthracycline. For the women who got a taxane in the HERA trial, the reduction in risk of recurrence was 23%, whereas for women who just got an anthracycline, it was much, much larger (I think 67% maybe). So, looking at the two studies it could be that the true benefit of herceptin after an anthracycline + taxane combo would be somewhere between 13% and 23%." ***And I had 6 Taxatere, Epirubicin and Cytoxan combined and dose dense***

2. One third of the women on the HERA trial were node-negative. ***Which I am***