HER2 Support Group Forums - View Single Post - Types of chemo tx, neo-adj vs. adj. etc

Becky · 11-13-2006, 10:37 AM

AC is not used instead of Herceptin. Usual protocol if using AC is AC followed by taxane with Herceptin then Herceptin alone until one yr of Herceptin has been used. In small tumors with no nodes involved, AC is used then followed by a year of Herceptin. Some oncologist who use AC like the AC followed by a taxane followed by Herceptin (not combining).

It is hard to say what the gold standard is. Adriamycin (the A in AC) or epirubicin (another anthracycline that is like Adriamycin) are used traditionally if one is Her2+ because Her2+ disease responses well to an anthracyclin. Current thinking now is that it is really being TopoIIA+ that is the responder to an anthracyclin but TopoIIA is strongly associated with Her2+ (about 57% of Her2+ cases are also TopoIIA+ as well). So, if you don't or can't get your tumor tested for TopoIIA, then one should take the anthracyclin based therapy (AC followed by perhaps a taxane and herceptin), because if you are topoIIA+, the bc responds well to the anthracyclin. If you are lucky enough to get tested, and are topoIIA negative, then TCH is good as it works very well and is easier on the heart.

I may come up with more later.

Kind regards

Becky

11-13-2006, 10:37 AM	#10
Becky Senior Member Join Date: Sep 2005 Location: Stockton, NJ Posts: 4,179	AC is not used instead of Herceptin. Usual protocol if using AC is AC followed by taxane with Herceptin then Herceptin alone until one yr of Herceptin has been used. In small tumors with no nodes involved, AC is used then followed by a year of Herceptin. Some oncologist who use AC like the AC followed by a taxane followed by Herceptin (not combining). It is hard to say what the gold standard is. Adriamycin (the A in AC) or epirubicin (another anthracycline that is like Adriamycin) are used traditionally if one is Her2+ because Her2+ disease responses well to an anthracyclin. Current thinking now is that it is really being TopoIIA+ that is the responder to an anthracyclin but TopoIIA is strongly associated with Her2+ (about 57% of Her2+ cases are also TopoIIA+ as well). So, if you don't or can't get your tumor tested for TopoIIA, then one should take the anthracyclin based therapy (AC followed by perhaps a taxane and herceptin), because if you are topoIIA+, the bc responds well to the anthracyclin. If you are lucky enough to get tested, and are topoIIA negative, then TCH is good as it works very well and is easier on the heart. I may come up with more later. Kind regards Becky