Becky: any further comment on Tykerb compared to Herceptin for response rate.

[heblaj01]

Becky,
you mentioned that at the SABCS you were let to understand by an expert that the anticancer activity of Tykerb was almost entirely with respect to activity against HER-2 not HER-1.
If this is so, for women who are assumed(for the purpose of this hipothetical question) to be HER-2 positive & are neither resistant to Herceptin nor to Tykerb which of the two drugs would be effective in the highest percentage of patients?
I suppose there is no scientific answer to the question but you may have heard some comments providing a few clues or can some tentative conclusions be drawn from the comparison of published clinical trials?

[Becky]

Mark Pegram made a blanket statement that antibodies are more active than small molecule inhibitors on Saturday night (12/16) - in reference to his discussion on Herceptin and Tykerb. When comparing response rates of Herceptin plus Taxol and now Tykerb plus taxol in the metastatic setting, Herceptin has a higher complete and partial response rate.


All data on Tykerb testing in women who are only Her1+ shows no response and all the "greats" to include Winer, Pegram and Slamon have presented using statements that Tykerb is a very weak Her1 inhibitor and only shows response if the patient is Her2+.

Please recognize that Tykerb is still a good drug. It truly will be a magic bullet for some as Herceptin was and is. I believe that Tykerb in combination with Herceptin will be great (attacking cancer from the inside and the outside). Along the pike comes other new molecules and these combinations will also be instrumental (with or without chemo regimes) to keep most if not all Her2+ women NED if recurrences occur. Even though Tykerb may not seem to be as good as Herceptin (when looking at pure numbers) it is how an individual responds to the drug that really matters and a good enough percentage of women do or else it would never get this far in clinical trials or upcoming FDA approval.

[heblaj01]

Thanks a lot Becky for the clarifications. Now please look at the small piece of article I posted at
http://www.her2support.org/vbulletin/showthread.php?t=26426

Herceptin+Avastin:big 83.8% response rate in small phase 2 trial (http://www.her2support.org/vbulletin/showthread.php?t=26426)

Any comments from the floor of the Symposium in San Antonio?

[heblaj01]

Becky, coming back to your above reply, I just found an other piece of info (dated 15 dec 06) which confirms your statement about the great usefulness of Herceptin even after progression:

http://www.roche.com/inv-update-2006-12-15c (http://www.roche.com/inv-update-2006-12-15c)
Efficacy in Advanced (Metastatic) Breast Cancer
Hermine
An observational cohort study investigated a large patient pool (623 patients) treated with Herceptin-based therapy under real-life conditions.<SUP>4</SUP> Continuing Herceptin treatment after disease progression is associated with a marked survival advantage for patients with advanced stages of HER2-positive breast cancer:

-The median overall survival was 16.8 months for the group who did not continue Herceptin. For the group who received Herceptin after disease progression, the median overall survival had not yet been reached at 27.8 months

-Overall survival at 2 years was greater than 70% for those who continued Herceptin treatment after disease progression compared with less than 25% for those who did not.

The fulll article carries info on various combos which include Herceptin.

[Becky]

http://webmail.att.net/wmc/v/wm/458B593600011F910000414B21587667559C07040401089F/SABCS_06_GNE_Release.pdf?cmd=MimePart&no=36&uid=627413&sid=c0&format=raw&mimepart=2.2&content_type=application/pdf&name=SABCS_06_GNE_Release.pdf

I am hoping this cut and paste works. We attended the Genentech Advocacy Luncheon and they gave us a presentation (which included info on the Herceptin + Avastin trial). They sent me this whole presentation today (and I am sure Sheila and Sandy H as well) so I pasted it here. I haven't even opened it. There wasn't much said about the Herceptin + Avastin trial in general and unfortunately, I did not attend that presentation.

[heblaj01]

Becky, the link does not work. It leads to a request for a password.

May be this needs a two step process where the second one calls for a temporary guest password. Any other intermediate link?

P.S.
I think I found the reason the link does not work if it is originating from the SABCS.
When I search the SABCS site for Streaming Webcasts I got this answer at http://www.sabcs.org/SymposiumOnline/index.asp#webcast :
Streaming Webcast
Audio and video highlights of SABCS are available via streaming webcast.
Slides and audio, as well as transcripts, are included. There are links for both fast connections (T1, DSL, and Cable) or slow connections (56K modems - audio only).

http://www.sabcs.org/Images/icon_webcast.gifPresentations from the 29th Annual SABCS Dec. 14 – 17, 2006
Supported by an educational grant from sanofi aventis.For a streaming webcast of selected SABCS 2006 presentations of particular interest click here (http://209.196.53.174/2006/).
The complete SABCS webcast will be available on or about January 30.

Only 5 webcasts appear to be available right now. So it will be a suspense until 30 Jan 06 unless you have an other way to access them sooner.
However I did find for reading an abstract of the presentation (but without comments) whose title is:
[301] Phase II combined biological therapy targeting the HER2 proto-oncogene and the vascular endothelial growth factor using trastuzumab (T) and bevacizumab (B) as first line treatment of HER2-amplified breast cancer.

Pegram M, Chan D, Dichmann RA, Tan-Chiu E, Yeon C, Durna L, Lin LS, Slamon D.. UCLA/Jonsson Comprehensive Cancer Center, Los Angeles, CA