Question for Jean

[Karen Weixel]

Jean,

I think I remember seeing that you had been tested for topo II. What test did they use to identify diagnosis?

Thanks,

Karen

[janet11]

I'm curious too, Jean. Karen, I was also tested for topo II, but have NO idea what test it was. I'll have to check my records and see if I have a copy of that one.

[Lala]

I thought of having the Topo II test prior to taking Doxil. The Topo II test is used to see if your tumor will respond to Anthracyclines. I was told you need to submit part of your tumor for this pathology test. It is still a test that is considered to be new and unreliable; not totally recognized by some leading cancer centers.
I believe the Topo II test is conducted at the University of Southern California.

[Jean]

Karen, Janet, and Lala,
Yes the TOPO 11 is used to test for response to Anthracycines.

Dr. Slamon ordered the test - a tumor paraffin slide was sent out
to his lab in Calif. (this is not an exspecnsive test a little over $250).

You will need to go to the hospital where you had your surgery and request that a paraffin embedded tissue block to be sent for sectioning.
The block will be returned after the sections are cut. Also will need to
send a pathology report as well. If a block is not available, then send approzimately 5-6 unstained sections on plus slides cut 3-4 microns thick.

The following is the Dr. that Dr. Slamon used:

Dr. Michael Press
USC/Norris Cancer Center
1441 Eastlake Ave. STE 5409
Los Angeles, Ca. 90033-0800
phone 323-865-0563

I am TOPO 11 negative...I am glad that I saw Dr. Slamon who is always
on the cutting edge of treatment...most dr. do not even know about
the test or otherwise do not believe it has any value. With the newer
treatments available we can save ourselves heart damage esp. if TOPO 11 negative
where you may not obtain the best benefits from the treatment.

Good Luck and of course if I can help further just reach out.

Hugs,
Jean

[tricia keegan]

I read a report last week which stated something like 92% of patients will not benefit from chemo if they do not over express the topo 11 gene as well as her2 gene. I'm just curious and hope you don't mind me asking but did you go ahead with chemo knowing you had tested neg for this gene and therefore knowing it may not help you ?? The report stated they don't have an approved test for this gene but will do soon and it really caught my interest. Thanks in advance for any reply.

[Jean]

Tricia,
I would love to read the article or send me a link.
Dr. Slamon explained it that TOPO 11 negative would not receive benefit
from A/C and along with herceptin may have unnecessary risk for heart damage. He recommended chemo - but TCH and the trial results were
excellant with this treamtent. I have not heard that the TCH would not
be as responsive to TOPO 11 negative. I did go forward with the TCH
treatment as he advised. Will give him a ring and ask him
about this. I have heard that HER2 positive in general can be resistive to
chemo - that was the driving force for Dr. Slamon with the development of hercetpin.

If you can send the article or link it I will forward it to him also.

Kind Regards,
Jean

[tricia keegan]

It was actually a thread here by Aquinnis and I see refers only to some chemo regime's. I found the whole thing very exciting and although my chemo is done how great it would be if this test could become more widely available as standard so other people don't have to go through it. Here is the link to the thread!
http://her2support.org/vbulletin/showthread.php?t=28475

[Karen Weixel]

Jean,

Thank you very much for your reply. My friend is an oncology nurse and a bc survivor who had never heard TOPO II or the test for it.

Karen

[Jean]

Tricia,
Yes, I remember that link. Thanks for posting again.

Isn't Dr. Slamon just amazing...that was in 2005...and here it is 2007
and STILL many Onc.'s do not even know about the TOPO11.
It makes me wonder.

God Bless,
Jean

[harrie]

My oncologist that first rec the Adriamiacyn/cytoxin said if the TOPO II was negative we could go witht the TCH instead. But at my consultation with Dr. Pegram, I BELIEVE he said the TOPO II results are not significant anymore for this kind of decision.

[TSund]

I asked our onc about this very issue on Friday. I asked if the fact that Ruth had responded so well thus far to TCH means that she is TOPO negative as we had been told by the earlier oncologist that we really needed to do AC + TH because it was the "standard of care" and because of the possible TOPO factor. (Ruth has not been tested)

Our new onc said, actually, TOPO positve women in general have a BETTER prognosis than those TOPO negative and this went for either chemo WHEN GIVEN WITH HERCEPTIN. Without the HER2+/Herceptin than the anthracylcines are called for in TOPO 11 positive. I don't know if TOPO positive women had better prognosis pre-Herceptin.

I belive this is also what Pegram has been saying with the latest stats. It would be great to get Slamon's very latest view on this ast his info has really been evolving even in the last few months. I don't believe the article referenced is even quite up to date.

But I am a newbie to this and could have this wrong!

[janet11]

And it may be that us TOPO2-neg people had a worse prognosis BECAUSE we were given anthracyclines and so often got a chemo that wouldn't help us. And with TCH or other chemo combos, maybe that prognosis is improved. Sounds reasonable to me. But this is simply my hypothesis.... not even bounced off my onc (*smile*).

Janet

[janet11]

Ahh... looked up my records. My Topo IIa test was done at OncoDiagnostics Lab (Veripath Laboratories), Southwestern Medical Center in Dallas. It was a Topo IIa FISH test (yes, FISH is the method they find this... just like the FISH test for HER2).

Mine TOPO IIa result was 1.3 and anything under 2.0 is 'non-amplified'.