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Hopeful · 07-20-2007, 07:12 AM

Bonnie,

Just for the sake of balance, I wanted to give you this link to my first ever post on this Board and the response I received: http://her2support.org/vbulletin/showthread.php?t=25170

There is some question about exactly what information the Oncotype test is providing to Her2+ patients; enough so that the TaliorX trial, which has divided patients into high, medium and low recurrence risk categories based on their Oncotype scores and randomized the medium risk group to receive chemo/endocrine therapy or just endocrine therapy has specifically excluded Her2+ patients from participating.

Of particular distress to me is the fact that the Oncotype test was validated retrospectively among a group of patients that took Tamoxifen only. In point of fact, the report says on its face, "Test results should be interpreted using the information in the Clinical Experience section below, which applies only to patients consistent with this clinical experience." The Clinical Experience Section reads, "The following results are from a clinical validation stydy with prospectively-defined endpoints involving 668 patients. The patients enrolled in the study were female, stage I or II, node negative, ER positive and treated with Tamoxifen."

It has been demonstrated that Tamoxifen treatment can not only NOT cause cancer arrest in some Her2+ patients, but, in a select group, can promote it. No one is addressing this issue, but I think it accounts for some of the stratospheric Oncotype scores that come back.

My own score was 44, with a 10 year 30% recurrence risk according to the test. I was dx post-menopause, 1.3 cm IDC (9mm invasive, with DCIS) ER+ (80%) PR+ (50%) Her2+++ by IHC, Ki-67 11%. The pathology and the Oncotype score seemed discordant to me. Additonally, from my research I learned that ER+, post menopausal women derived the least benefit from chemotherapy of any class of bc patients. I had lumpectomy, radiation, and declined chemotherapy, having found an oncologist who would treat me with Herceptin without chemo. My treatment plan is 1 year of 3 weekly Herceptin and 5 years of an AI.

You and you alone can decide what is best for you; you are the one who will live with the decision. I just wanted you to know that not all of us go down the same path.

Hopeful

07-20-2007, 07:12 AM	#18
Hopeful Senior Member Join Date: Aug 2006 Posts: 3,380	Bonnie, Just for the sake of balance, I wanted to give you this link to my first ever post on this Board and the response I received: http://her2support.org/vbulletin/showthread.php?t=25170 There is some question about exactly what information the Oncotype test is providing to Her2+ patients; enough so that the TaliorX trial, which has divided patients into high, medium and low recurrence risk categories based on their Oncotype scores and randomized the medium risk group to receive chemo/endocrine therapy or just endocrine therapy has specifically excluded Her2+ patients from participating. Of particular distress to me is the fact that the Oncotype test was validated retrospectively among a group of patients that took Tamoxifen only. In point of fact, the report says on its face, "Test results should be interpreted using the information in the Clinical Experience section below, which applies only to patients consistent with this clinical experience." The Clinical Experience Section reads, "The following results are from a clinical validation stydy with prospectively-defined endpoints involving 668 patients. The patients enrolled in the study were female, stage I or II, node negative, ER positive and treated with Tamoxifen." It has been demonstrated that Tamoxifen treatment can not only NOT cause cancer arrest in some Her2+ patients, but, in a select group, can promote it. No one is addressing this issue, but I think it accounts for some of the stratospheric Oncotype scores that come back. My own score was 44, with a 10 year 30% recurrence risk according to the test. I was dx post-menopause, 1.3 cm IDC (9mm invasive, with DCIS) ER+ (80%) PR+ (50%) Her2+++ by IHC, Ki-67 11%. The pathology and the Oncotype score seemed discordant to me. Additonally, from my research I learned that ER+, post menopausal women derived the least benefit from chemotherapy of any class of bc patients. I had lumpectomy, radiation, and declined chemotherapy, having found an oncologist who would treat me with Herceptin without chemo. My treatment plan is 1 year of 3 weekly Herceptin and 5 years of an AI. You and you alone can decide what is best for you; you are the one who will live with the decision. I just wanted you to know that not all of us go down the same path. Hopeful