Pattern of recurrence of early bc differs by intrinsic subtype & proliferation index
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Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
Here you go Linn65:
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Only 25% of the patients had received a taxane, and only 18 patients in this analysis received Herceptin. Since the patient information is prior to 2009. It is good information from a historical perspective. I can't wait to see how Herceptin has changed Her2 from what is so obviously the worst diagnosis to one of the luckier and more treatable breast cancer. |
Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
I'm still digging out nuggets from the article and found a couple more interesting pieces. The first is about Her2, margins & early recurrence:
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Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
What I found interesting was this:
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I recall discussion here from way back, that perhaps triple positives could do with a "booster" of Herceptin at the 5 or 7 year mark. Hopeful |
Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
This shows a novel shift in the management of preventing recurrence and not just treating intial cases or recurrences. The suggestion is to use Herceptin in the future to prevent many Her2 positive cancers that recur in the 5-6 year range.
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Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
That is just too weird Hopeful. We are on the same page!
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Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
Has anyone done a clinical trial with the triple positives and a second round of Herceptin? I think prior to the 5 year mark, 48 to 50 months would be the safest strategy for prevention. (and I personally would want more than 1 booster, maybe 1 per month for 6 months.)
I also wonder what affect the E75 or AE37 vaccines are having on the late recurrence rates. This is just such a change in thinking from the wait and see, and let a huge percentage of women recur. I would love changes to the standard of care. |
Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
Triple positive recur about the 5-6 year mark, isn't that about the time the 5 year treatment of Tamoxifen is up? This might also be a factor.
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Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
WHEW Mister Sister...VERY, VERY INTERESTING...!!! I usually do try & read what is posted in some of these articles (when I have time...) just don't comment, what can I say, except that this information is beyond me...knowledge is power!! :)
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Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
I'm not fond of the wait & see, and try to find symptoms system of cancer surveillance. If we can find a way to prevent or some less invasive testing to screen survivors - I'm waving my pom poms!
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Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
I wonder how many oncs/insurance companies would prescribe the booster shots though? I for one would love a top up in 18 months - would seriously pay out of pocket too - but would need the doc to go with my wish and probably some data!! Great topic though thank you xx
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Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
The "booster" would be easier, now that Herceptin is becoming available in forms other than infusion (i.e., subcutaneously). It would be less expensive than having to go to an infusion center. I do think that this would need to be tested before it becomes standard practice.
Hopeful |
Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
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Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
Hopeful & 'lizbeth, thank you so very much for extracting so much valuable information...as to "wait & see, symptoms...!!" I'm going to share this article with my oncologist, he always tells me IF I can find anything that would convince him, he would be willing to take a look at it...hmmm...(yeah, right?!?!)...
I find some articles of interest from "PracticeUpdate", Oncology Daily Digest...I'm sure others of you read that as well. Kinda off the subject...very, much...anyhow, a year ago this month is when I found my "pea"...NOT from a mammogram or ultrasound...and today I go for my yearly mammogram, the only one I still have...trust me, I've called them already & explained "where I'm coming from..."...makes no difference as we know "dense breasts"... Okay...didn't mean to go there...I'm with you JennyB...all over this "Booster"...it just may be adding up...hmmm... |
Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
I like the idea of the booster.
After looking at Hopeful's prior conversation I see perhaps two higher risk times, one about a 2-2 1/2 year interval, another at 5-6 years with ER+, Her2+. I love the idea of the Herceptin injections as boosters. Do we really need a clinical trial? Almost all have had an entire year of Herceptin infusions. For stage 1-3 who remain as NED this has been for prevention. To receive an injection booster at 18 months, then 24 mths, 48 mths and 60 mths for ER+, Her2 patients should be something left to the discretion of the oncologist and patient. "Modern" medicine will never achieve personalized care if the FDA has to approve & micromanage everything based on clinical trials for the good of the group, and not the individual. |
Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
I'd do a booster in a heartbeat and I still have one more Herceptin to go (next Wednesday, Oct 30th).
But would it just be one "loading" dose or a couple of doses? I know there are no answers... Susan - your mammograms now should be diagnostic vs. screening and you should get the results before you even leave the facility. Prescription should be written that way. Best Janis |
Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
Smart People than I,
I am a bit confused by this study and think I must be reading it wrongly. Please, if anyone can, help me to wrap my brain around this. On page #14 in table #9 I see that the hazard ratio for recurrence in Luminal Her2 is actually declining annually through years 5-7. It appears that Her2 Enriched does spike around year 5, however. Isn't Luminal Her2 that which is Er or Pr (or both) positive and Her2 positive (Er/pr+, Her2 +) while Her2 Enriched is Her2 positive, but hormonally negative (Er/Pr-, Her2 +)? I must be reading that table wrongly because according to my interpretation Luminal Her2s would not require a booster, but Her2 Enriched would qualify. Anyone? |
Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
Laurel,
We picked it up off of page 4 - from other studies: Quote:
From prior reading I was under the impression that Her2 positive, hormone negative cancers recurred within the first 2 years then dropped. Recurrences with Her2 Positive ER Positive cancers had a tendency to occur more frequently beyond 2 years. I think this brings us back to the prior discussion: Who is recurring? and the fact that SEERS does not track this type of data. I will take another look . . . |
Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
Just so we understand for the purposes of this study Luminal Her2 is defined as:
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Re: Pattern of recurrence of early bc differs by intrinsic subtype & proliferation in
If you look at page 12 under: Analysis of recurrence prognostic factors and variations in recurrence risk over time
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