Can Herceptin Wipe Out Cancer Stem Cells?

[Becky]

http://www.medpagetoday.com/MeetingCoverage/AACR/19625

[Rich66]

Mathematical modeling suggests that even in women whose breast cancer does not overexpress the HER-2 gene, treatment with trastuzumab (Herceptin) in the adjuvant setting could wipe out cancer stem cells, researchers reported here. "We predict that a year of trastuzumab therapy would likely eradicate breast cancer stem cells in patients in which the tumor overexpressed HER-2," said Mary E. Sehl, MD, PhD, of UCLA, during a poster presentation at the annual meeting of the American Association for Cancer Research.
Sehl added that if trastuzumab were prescribed for patients with tumors that expressed normal levels of HER-2, the treatment would still drive the breast cancer stem cells in that population to extinction -- but it might take three to four years of therapy.


I've heard before that there is some thought that breast cancer stem cells are her2 pos.

This idea of Herceptin working on cancer stem cells might explain continued Herceptin benefit after progression...progression thought to be expressed by faster cycling non-stem cells. Another reason to wonder if measuring visible growth in short intervals might be misleading at times.

[schoolteacher]

Becky,

This is a very interesting article. I wonder how they determined that it would take three or four years for the stem cells to become extinct?

Sehl added that if trastuzumab were prescribed for patients with tumors that expressed normal levels of HER-2, the treatment would still drive the breast cancer stem cells in that population to extinction -- but it might take three to four years of therapy.

How does that relate to some people only having one year of Herceptin.

I have finished two years of Herceptin and started on my third year.

Could that mean after three or four years the stem cells could possibly be extinct in my body?

Amelia

[Ellie F]

Hi Amelia
I asked my onc that same question at my last visit.My centre is involved in a study looking at that very issue. She said opinion is very divided on the existence of stem cells and further divided on their capabilities and life span!! She added that some colleagues believe that if you can eradicate most of them then the immune system can keep them in check but if large numbers are present they overwhelm it.
Ellie

[schoolteacher]

Ellie,

Please let me know if you find out anymore information about this topic.

I go for my Herceptin infusion on Thursday. I am going to take the article with me. I want to see what his opinion is about this topic.

I am afraid to come off Herceptin. If I knew that I could come off Herceptin in three or four years, it would give me some light at the end of the tunnel.

Ellie, I also did the vaccine at the University of Washington, and I am waiting to hear the results.

Amelia

[Ellie F]

Amelia
Will let you know if I get anymore info. Are you on long term herceptin due to a recurrence? Sorry I can't remember your history.

Cheers Ellie

[schoolteacher]

Ellie,

I was stage IV from the beginning. I had BC in my L4. The tumors had covered most of my breast, except for one quardrant.

AC did nothing to my cancer. I did this chemo for six weeks when the doctor figured out it was not working. My first herceptin and taxol treatment, I could feel my tumors shrinking. It was one of the most wonderful feelings I have ever had in my life.

Amelia

[Midwest Alice]

Amelia,

My onc is going to keep me on Herceptin for 5 years. Then we will talk. The treatment in pill form for ER+ women is 5 years so he thinks it is with in reason to take Herceptin for 5 years. I don't want to get off either.

Hugs, ALice

[Ellie F]

Hi Amelia
Thanks for your reply.I did 4 rounds of AC with very little change and a 'disappointing' report from the pathologist according to my onc! He went onto only give me herceptin and in my ignorance I thought this was alright. it was only a year later when I recurred in the contra lateral axillary lymph glands did I get another opinion and several rounds of taxotere with herceptin.My onc is saying I will stay on herceptin long term in the hope of keeping it at bay but if it recurs again will add to not take away herceptin.
Cheers Ellie