her2 serum test

[Mary Jo]

On June 5th I go in for my 6 month check up with my onc. I am approaching my 3 year NED date (July 08) and wondered if I should bring up the her2 serum test. A baseline? Is that something I want? Is that something beneficial to someone like myself? I am er/pr negative and not sure if that is a factor in this test either. I don't know much about this test and any help from you who know about it would be much appreciated.

Thanks for your help.

MJ

[hutchibk]

I have been asking my doc about the Elisa test, and he says there is not yet a standard by which to interpret the data, so he's not yet interested in it, says it's not ready for prime time, and that's why ASCO still doesn't recommend it.

Yet I know others are having it done...

Wonder where I can find compelling info so he and I can further the conversation?

[Mary Jo]

What is the "Elisa" test? Is that another name for her2 serum or is that another test?

MJ

[hutchibk]

I believe it is one of a few different circulating tumor cells (CTCs)/HER2 serum tests that exist. But upon googling it, it does seem that there is not a gold standard of this type of test. Hmmm. I intend to keep my ear to the ground on this, but those more knowledgeable, please do contribute... Maryjo and I need to learn more!

[Lori R]

I too asked my onc about the test.

I was especially interested as the standard blood tests are not a reliable indicator for me. (rats) So, it means that I have been on a quarterly PET/CT scan as my detection method.

My onc also said that the test wasn't ready for prime time.

I love this type of information as it provides additional confidence in my onc as she is saying the same things that other Drs. are saying.

So...it sounds good to me to collectively keep up with the status on the testing development. I would be very interested in using some other tool that Pet Scan to know if there is a party going on inside of my body.

[ElaineM]

Hi,
Humm. I have never heard of it, but I will do a search on it. I thought the FISH test was the only way to determine if a person is Her 2 positive and we need a biopsy for that.

[hutchibk]

Elaine - the Her2Serum and CTCs are blood tumor markers to follow potential recurrence, activity and progression - not used to determine Her2 status.

[ElaineM]

Hi,
Thanks for the information.

[Joan M]

Hi Marejo,

Siemen's has a serum test but it's for women with metastatic breast cancer.

I'm interested in that test and had asked Kate about it. She used the test and said that it was a really good marker for her.

I think there's another test but it may be for ER+ bc. Perhaps someone on the board has more information about that.

Joan

[Mary Jo]

Thanks Joan. I did think the test was for those with metastatic disease but wasn't sure. I also did hear something about a test (thought it was this one too) where you had to be er positive.

Have a happy day.........

MJ

[abitjaded]

ELISAs, IHC and Fish are different.

http://en.wikipedia.org/wiki/ELISA

ELISAs are often scaled up, routine, in some respects. They go in a big plate with wells the size of paper punches. The antibody is stuck to the plate and your serum goes on with a probe, that if it binds to the plate, the well glows with a fluorescent probe, and can be run in huge numbers through an automatic reader.

IHC is Immunohistochemical, antibody stuck to a radioactive or color probe, more a test tube kind of reaction. Done with smushed tumor cells. The number is a concentration compared to normal.

Fish, is Fluorescent in situ Hybridization. They make a smear of your tumor cells. Smoosh the cells on a slide (or preserved in a thin sliced block) so the chromosomes are spread out. Then add a probe that makes the DNA glow just where the Her2 gene is. That way they can look at each cell, which proportion of the cells, how many copies of chromosome 17 in each cell. The >3 designation so many of us have means 3 or more copies of the her2 gene per cell.

Sorry, biologists answer.

Carla

[swimangel72]

Great info Carla - thanks!

[Unregistered]

Do you feel you need a further confirmation of your Her2 test results? Were you Her2 positive by an IHC test or by a FISH test?

[Susan2]

Is anyone using the Her2 serum test for markers? Do you know the approximate cost?

Thanks.

[Janelle]

I asked Dr. Slamon if there was a reliable test to see if Herceptin would work for me as I understand it doesn't work for everyone who overexpresses HER2. He told me there was no reliable test. I'm not sure if this is the type of test to which you are referring though.

[Jean]

The Her2 Serum test is a biomarker test for tumor cells in the blood, it is rather new and many dr. are not using it. It does not inform you if herceptin is working for you. Rather it will show amount of her2 serum levels in the blood which would help you monitor your treatments.

Remember that during treatment you could be shedding dead cells into the blood and your levels may not indicate that herceptin is not working - maybe the chemo is not /so/a change in the chemo maybe the answer.

While we were out in S.D. we all had dinner with the
dr. who was the inventor of the test.

It is primarily for those who are in treatment for metastatic disease in order to check levels and to monitor if the treatment is working. It is important to have the test prior to treatment in order to achieve a base line.

Now, for those on cutting edge...this reminds me of the Oncotype DX test...in its early days, now being used by many onc. to determine if chemo should be used taking the guess work out of the equation, instead of using tumor size and node status, the Oncotype DX goes to the source, your very own gene makeup.

When I was speaking with the dr. he felt it would be a good idea to have a base line by having the test, my onc. in NJ does not use it for those with early stage.
I have not discussed it with Dr. Slamon/to ask if this is worth while. It is not invasive/so/if anyone is concerned it is just a blood test (I do not know the cost) but as Brenda mentions it is not written in stone yet and certainly not for early stagers, just yet. If anyone is interested I would be happy to contact the
dr. who invented the test and find out how much the cost is. I had planned on having the test as a baseline for myself. But my markers have been low as I go in for my 3 month checkups and I have felt satisfied.

Also, remember when having treatment in the early days and months of treatment the tumor cells are shedding and the level could be high so the test is
not ready for prime time just yet.

Ah, it seems we get one answer and then more quesions?

Hope this helps clear up any confusion.
I have posted a link.
http://diagnostics.siemens.com/webapp/wcs/stores/servlet/PSGenericDisplay~q_catalogId~e_-111~a_langId~e_-111~a_pageId~e_79003~a_storeId~e_10001.htm

Regards,
Jean

[Janelle]

Excellent intelligence, Jean. I do not have mets but it makes sense for me to get a baseline now that I am finished with chemo and herceptin. It seems like this would be a logical way to show progression before other technologies pick up on something and diesease load increases. I would love any further info on the test (cost, etc) as I am determined to have this done.

Thank you so much for clarifying what the test was for and giving us the inside scoop. I am considering a vaccine trial for non-mets people. I think this would help me evaluate if the vaccine is working (assuming I don't get a placebo!).

Best,
Janelle

[Midwest Alice]

Any new information on this blood test and when to have it done?

Thanks,

[Joe]

There is also a lot of information available elsewhere on our website: Tests and Treatments (http://her2support.org/index.php?option=com_content&task=view&id=42&Itemid=64).

Although the test is currently approved only for Stage IV metastatic bc. There is enough evidence that it is also effective for earlier stages. I understand that Siemens is currently considering petitioning the FDA to approve the test for these patients.

The test costs approximately $300.00 and most insurance companies will pay regardless of stage.

Regards
Joe