also unable to access yet--does her2 increase incidence of brain mets?

[Lani]

: Nat Clin Pract Oncol. 2006 May;3(5):236-7. Related Articles, Links

Does trastuzumab increase the risk of isolated central nervous system metastases in patients with breast cancer?

Weil RJ.

RJ Weil is Associate Director of Laboratory Research in the Brain Tumor Institute at the Cleveland Clinic Foundation, Cleveland, OH, USA.

PMID: 16682997 [PubMed - in process]

[RobinP]

I hope it doesn't there certainly was not an indication of this in the preliminary HERA trial.

[Joe]

The theory that Herceptin causes brain mets was first proposed around 2001. It has since been debunked by many researchers. The problem is that Herceptin, because of its large molecular structure, does not cross the blood brain barrier and is thus ineffective in treating and preventing brain tumors.



A paper also published last year at SABCS , disclosed that women who are HER2 positive have a higher incidence of brain mets than other bc populations. This is largely due to the aggressiveness of HER2 positive disease .



Dr. Eric Winer, who is on our advisory board, has done considerable research and work treating brain mets with Tykerb and combinations. Hopefully he will present some information about his research next month at ASCO. Dr Winer WILL be presenting the clinical trial results of Tykerb in treating Metastatic breast cancer on Saturday June 3rd.



Our group will also be attending ASCO and will be talking to GSK’s neuro-oncology scientists about their research in this area.



We will also be distributing an awareness paper describing the surveillance, treatment and available resources in treating CNS tumors to the oncologists and researchers attending this meeting.



The writing and initial printing of this document was made available through generous grants to our group from Elekta/Leksall and The CINN Foundation of Chicago.



Future printings will dedicate this document to Mary Crawford and Linda Schmidt, 2 of our former members who passed away prematurely because their tumors were diagnosed too late to be treated.



Regards

Joe

[Cathya]

Joe;

I recently had a brain CT with contrast. I questioned the tech's about the differences between it and an MRI as I was concerned that the tumor size would have to be too big before it was identified on a CT. They assured me that this particular CT machine was the "gold standard" and they have had referrals from onc's with patients with identified tumors by MRT to gather more information using these machines. I am still uneasy and wonder your opinion. I do know that here in Canada CT's are easy and cheaper and the standard of care. I am prepared to pay for a brain mri which I can get just accross the river in Quebec very quickly. Should I do so? I am stage 3c as I had a 1 cm tumor in my clavicular node. ER/PR + on arimidex. Herceptin halted for now.

Cathy

[Joe]

Cathyn
Here is a quote from the paper that we will be distributing at ASCO:

"Computed tomography (CT) era data suggest that brain metastases from solid tumors tend to be single or solitary in 50 percent of patients at diagnosis. However, more recent studies based on magnetic resonance imaging (MRI) suggest that less than one third of patients have a solitary or single brain metastasis at the time of diagnosis of brain metastasis. Such a considerable difference in sensitivity is an indicator of the inadequacy of CT in determining the number of brain metastases or in detecting small (millimeter size) metastases.[i] (http://her2support.org/vbulletin/newreply.php?do=newreply&noquote=1&p=91908#_edn1)

[i] (http://her2support.org/vbulletin/newreply.php?do=newreply&noquote=1&p=91908#_ednref1) M. Vogelbaum, and J.Suh. (2006) Resectable Brain Metastatses. Journal of Clinical Oncology 24, no.1289-1294."

It would suggest the MRI's are superior to CT s.

Regards
Joe

[Cathya]

Thank you Joe. I guess my view would be that if brain mets were found early enough targeted radiation along with Lapitinib should be effective in treatment. Any other ideas? I am not familiar with brain mets but like to be prepared to discuss this with my onc as I see him on the 24th to discuss my CT.

Cathy

[R.B.]

Could you ask the boffins at ASCO

1. Does herceptin impact on FAS (A trial I have seen suggests it does)

2. How does it impact on FAS

3. Does the impact of Herceptin on FAS include blocking synthesis of long chain fats (particularly in the EFA pathways omega three and six).

4. Does this include all long chain fats or just selected pathways EG. to AA Arachnidonic acid or DHA as well.

5. If Herceptin resticts long chain synthesis including DHA could it render the brain more suspeptable to metasitc spread of BC AND OR the other conditions related to DHA shortages (See SMART FATS by A SCHMIDT), particularly given the common low levels of intake of foods rich in DHA evident in western diet?


RB