Herceptin without chemotherapy

[petesmom]

Joe or Christine,

Do you see on the horizon apoint at which women will be given Herceptin independently without ever having been given chemotherapy? I fall into that gray category of having been diagnosed in March 05 with a 7mm tumor IDC amidst a small area of DCIS. The tumor was ER+ (80%), Grade 2 with no nodal involvement. This was a second breast cancer, new primary, so I had a mastectomy. I have never had chemotherapy as I had rads and lumpectomy for first cancer which was NOT HER2+. No residual cancer was found in the breast tissue removed. My oncologist put me on Tamoxifen (I am 52 years old but premenopausal) saying that the risks of giving chemo to get the Herceptin outweighed the benefits. Just curious as to what you think and would like others to weigh in as well. Thanks so much and your website is terrific.

Lucy

[*_Bonnie_*]

hello
I sure hope they do, I know there are people on this board with very good information. I don't know what the rules are for herceptin. I finished chemo. last year and just started Herceptin, I have had to stop because it is hard on my heart and need to get that taken care of first. So I know what it is like wanting to take it.!!!!
Bonnie T

[Janet/FL]

I was diagnosed in Nov. 04 with lumpectomy 12/04. .9mm tumor ER/PR- Her2+++. Node negative. Radiation ended in March. I opted out of AC chemo as recommended by two Oncs. I found a new onc last month who offered me Herceptin with or without chemo. I took the chemo. I started 8/8/05 and am doing fine. Taxotere/Herceptin every week for about 16 weeks then Herceptin for one or two years? He will not be there after a few months so next onc will make that decision.
If you want Herceptin--go get it. You can argue that it is still adjunctive therapy as you are less than 6 months out of treatment. But I would hurry if I were you, if you want it, though I think my onc would have given it to me anyway
Janet.

[jpuk]

When reading this reply, bear in mind that I am in London, UK.

I started Herceptin last Monday, 22nd August. I was diagnosed last December with primary Inflammatory Breast Cancer. Due to the severity of the diagnosis I was on chemotherapy the next working day; underwent 6xFEC. Mastectomy 8 weeks ago. As I have recently posted here, Herceptin is not generally available in the UK, and National Health Service guideline use is currently for secondary cancer only (although you can buy it privately if you are wealthy enough!) My own condition is categorised by my oncologist as "locally advanced" and therefore falling within government guidelines.

I have had a port inserted (itself extremely unusual in the UK: I asked for it because I found the Hickman line which had to be installed for chemotherapy to be extremely troublesome) and later the same day I received the first intravenous Herceptin infusion.

To sum up: having previously received chemotherapy I am on Herceptin ONLY for a primary, advanced, cancer.

[Gina]

I know what I am about to say is HIGHLY controversial, but I believe HERCEPTIN alone in CERTAIN individualized cases is the ABSOLUTE best way to go. I find this to be particularly true if one is ER-PR-and Her-2+++. There is a historic reason for the Herceptin with or without chemo debate. Early on, the first trials seemed to suggest that HERCEPTIN WITH CHEMO was the way to go...Unfortunately, as is so often sadly the case, when they went back over the data they realized, much to their chagrin that the reason this happened was because a lot of folks in the early trials were NOT her-2 positive at all...this skewed the data as follows using a made-up analogy...IMAGINE a trial with two arms...Herceptin only and Herceptin plus, say Taxol. Now imagine 5 women in the Herceptin only trial are positive for her-2 and 5 other women are completely negative for her-2, immediately, the highest percent of women who will POSSIBLY be able to respond is cut in half right off the bat...while on the other arm...let's say you have 5 people positive for her-2 who most likely will respond to the herceptin part of the combo and 5 other her-2 negative folks who may have at least some chance of responding to the taxol by itself...We do not have to have "BRILLIANT MINDS" or be John Nash (from my hometown Bluefield by the way) to do the math...this is in a nutshell what happened. More recent studies have more than proven the superior efficacy of using Herceptin alone, if and WHEN the person is extremely HER-2 positive as in +++....hopes this clears things up...at some point I will relocate the studies and post them for us all, Gina

[Janet/FL]

Gina writes:
hopes this clears things up...at some point I will relocate the studies and post them for us all, Gina

Janet Replies
Yes, Gina, please do since I am in a postition that I can stop the Taxotere and continue with the Herceptin. But have not seen the studies that would back up your claim. Would be glad to forward them to the Research Nurse for her opinion.
Also, you talk about markers for Her2. What type of follow up tests would you do after the tumor itself has been removed and tested? My two oncs, do not like the Bayer Serum test. Is there another one?
My regular tumor markers remain very low, but they were very low prior to my lumpectomy.
Thanks
Janet/FL