Is Stable really "good?"

[Ceesun]

Good evening all, After a recent ct scan with my onc., he said the results were good that my lung met was stable and he was pleased. He said it wasn't doing anything or causing problems and compared it to a person with diabetes...keeping the sugar in check. We have now added tykerb about 2 weeks ago. I had been on xeloda only since May. I wonder if adding the tykerb will be helpful.... I pray it will. Any thoughts...it sure has been a tough 6 months with the losses on this board. Ceesun

[hutchibk]

Joe posted this on another thread today -and it might answer your question a little!


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Prognosis of women with stage IV breast cancer by HER2 status and trastuzumab treatment: An institutional based review.

Sub-category:

Metastatic Breast Cancer (http://www.asco.org/ASCO/Abstracts+%26+Virtual+Meeting/Abstracts?&vmview=abst_category_abstracts_view&confID=55&subCatID=3)

Category:

Breast Cancer--Metastatic Breast Cancer

Meeting:

2008 ASCO Annual Meeting (http://www.asco.org/ASCO/Abstracts+%26+Virtual+Meeting/Abstracts?&vmview=abst_meeting_categories_view&confID=55)

http://www.asco.org/ASCO/Images/General/print.gif Printer Friendly (http://www.asco.org/portal/site/ASCO/template.RAW/menuitem.34d60f5624ba07fd506fe310ee37a01d/?javax.portlet.tpst=0e116779df458209ada2be0aee37a0 1d_ws_RW&javax.portlet.prp_0e116779df458209ada2be0aee37a01d _viewID=abst_detail_rawview&javax.portlet.begCacheTok=com.vignette.cachetoken&javax.portlet.endCacheTok=com.vignette.cachetoken&index=n&confID=55&abstractID=35007)

http://www.asco.org/ASCO/Images/General/email.gif E-Mail Article (http://www.asco.org/ASCO/Abstracts+&+Virtual+Meeting/Abstracts?&vmview=abst_detail_view&confID=55&abstractID=35007#)

http://www.asco.org/ASCO/Images/General/clear.gifhttp://www.asco.org/ASCO/Images/General/clear.gifhttp://www.asco.org/ASCO/Images/General/clear.gifAbstract No:

1018

Citation:

J Clin Oncol 26: 2008 (May 20 suppl; abstr 1018)

Author(s):

S. S. Dawood, B. Kristine, G. N. Hortobagyi, S. H. Giordano

Abstract:

Background: HER2 +ve status is traditionally known to be associated with poor prognosis. Recent studies have shown that the addition of trastuzumab to the treatment of women with HER2 +ve disease significantly improves survival in early and advanced stage breast cancer. The purpose of this retrospective study was to determine if the addition trastuzumab in a cohort of women with stage IV HER2 +ve breast cancer improves prognosis beyond that of women with HER2 -ve disease. Methods: Women with de novo stage IV or recurrent breast cancer diagnosed between 1991-2007, with known HER2 status, who had not received trastuzumab in the adjuvant setting, were identified from the M. D. Anderson database. Disease was classified into three groups: a) HER2 -ve disease, b) HER2 +ve disease without first-line trastuzumab treatment, c) HER2 +ve disease with first-line trastuzumab treatment. Overall survival (OS) was defined as the time from the date of first distant metastasis to the date of death or last follow-up and was estimated using the Kaplan-Meir product method and compared between groups with the log-rank test. Cox proportional hazards were used to determine associations between OS and HER2 status after controlling for patient (pt) characteristics including year and age of diagnosis and site of first metastases. Results: The final analyses included 2,091 pts. One hundred and eighteen (5.6%) pts had HER2 +ve disease without trastuzumab treatment, 191 (9.1%) had HER2 +ve disease and trastuzumab treatment and 1,782 (85.3%) pts had HER-2 -ve disease. Median follow-up was 16.9 months. One year survival in pts with HER2 -ve disease, HER +ve disease who received trastuzumab and those with HER2 +ve disease who did not receive trastuzumab was 75.1% (95% CI 72.9%, 77.2%), 86.6% (95% CI 80.8%, 90.8%) and 70.2% (95% CI 60.3%, 78.1%) respectively. In a multivariable model women with HER2 +ve disease who received trastuzumab had a 44% reduction in the risk of death compared to women with HER2 -ve disease (HR 0.56, 95% CI 0.45-0.69, p<0.0001). Conclusions: The introduction of trastuzumab has altered the natural history of HER2 +ve breast cancer. Our results show that the addition of trastuzumab improves the prognosis of women with HER2 +ve disease above and beyond that of women with HER2 -ve disease.

[SoCalGal]

Hi CEESUN-
Stable is good. It sounds like your onc is adding in some tykerb to tip the stable state into shrinking and disappearing. The Tykerb/Xeloda combo has been very effective for many and we'll help you manage any side effects. Flori

[Pam P]

Ceesun - I am always happy to hear the word 'stable' with the results of my scans. I've longed to hear 'NED' ---- or 'CURED', of course, but haven't yet. As long as I can stay 'stable' with my treatments, feel good most of the time, and continue on with life I feel blessed. I agree with your onc.- if this can be similar to maintaining a 'level' like blood sugar for diabetes, then it sure beats the alternatives.

[PinkGirl]

Hi Ceese,
Yes, stable is good. It is better than not stable or
unstable or stabley-challenged.

I think stable is great!!! Congrats.

[chrisy]

Yes, stable is good. Sort of like turning 50 or 60 or 70 (great when you consider the alternative!)

I know that deep down what we really want is, as Pam said, NED or cured. Or at least some retreat. So I know how you feel, and it is a challenge to really embrace "stable" as a good thing, even though we know that we'd LOVE to manage this as diabetes for years and years if we can.

[Believe51]

Stable, NED, Remission.....ALL GOOD TO ME SWEETIE!!!! I recently asked the same thing...Go get 'em Girl

Love>>Believe51

[hutchibk]

Stable means 'no activity' and that is what we like to hear!!

[Joan M]

Ceesun,

Stable is good. It's not spreading and is under control.

I know that you and I have discussed why you can't proceed with lung surgery or lung radiofrequency ablation since you have had only one nodule which has become NED before with Herceptin and Xeloda. So I think it's good that your onc wants to add Tykerb to try to shrink the nodule again.

And anyway, even though I had the RFA, I'm still going to add Xeloda to the Herceptin I currently take because of the local recurrence after last year's wedge resection, and I was on Herceptin. You're the best and have been wonderful to me. I'm praying that the Tykerb will do the job.

Joan