HER2 Support Group Forums - View Single Post - Scary article--mentioning the "dark side of Herceptin"w stats cardiotoxicity/brnmets

Lani · 07-20-2007, 04:00 PM

Herceptin has made an incredible improvement in the survival statistics of those with her2+ breast cancer, but it comes with a cost (the cost is FAR
FAR LESS THAN THE BENEFIT when looking at large numbers of patients, but can be important if any one patient is one of those minorities who suffers from either heart failure due to herceptin or brain mets, which may not be DUE to herceptin, but are found more frequently in those treated with herceptin than in those who are not)

They tried to put numbers on these risks based on combining the many clinical trials that took place which allowed herceptin to get FDA approval:

What I posted before:
The good news is they don't prove causation of brain mets. Will have to look further at the article to see if they took into account that herceptin treated patients may just live longer and thus have time to develop brain mets which would have developed eventually in the nonherceptin treated patients who died before they happened (or got big enough to give symptoms)

Also, at least they did put numbers on it ie, for every 161 persons treated with herceptin you may have had brain mets which otherwise would not have occurred if herceptin had not been given and although every 14th patient treated may have gotten symptomatic heart failure that they otherwise might not have had, you had to treat 64 to get asymtomatic heart toxicity (which by other reports is treatable and reversible)

Perhaps better some numbers than no numbers (and only one's imagination which is usually worse! )

"The DFS, DDFS, and OS were significantly better in the T-arm, with an AD of 6.00, 4.80 and 1.96%, which translates into 16, 21 and 51 NNT respectively"--This means they only had to treat 16 patients for two years to show an improvement in disease free survival in one, 21 patients for two years to see increased distant disease free survival ie, mets, in one and 51 patients to see an increased overall survival, as I understand it. Hopefully as results mature with longer follow-up of patients the benefit wil show itself even more strikingly.
Their Conclusion was: The overall outcome results show that trastuzumab is one of the most important discoveries in oncology.
But they hedged and said we need to understand how it works better in order to decrease side effects so that the risk/benefit ratio is even more
impressive.
Hope this helped.

07-20-2007, 04:00 PM	#4
Lani Senior Member Join Date: Mar 2006 Posts: 4,780	Bonnie the follow is my translation--some already posted Herceptin has made an incredible improvement in the survival statistics of those with her2+ breast cancer, but it comes with a cost (the cost is FAR FAR LESS THAN THE BENEFIT when looking at large numbers of patients, but can be important if any one patient is one of those minorities who suffers from either heart failure due to herceptin or brain mets, which may not be DUE to herceptin, but are found more frequently in those treated with herceptin than in those who are not) They tried to put numbers on these risks based on combining the many clinical trials that took place which allowed herceptin to get FDA approval: What I posted before: The good news is they don't prove causation of brain mets. Will have to look further at the article to see if they took into account that herceptin treated patients may just live longer and thus have time to develop brain mets which would have developed eventually in the nonherceptin treated patients who died before they happened (or got big enough to give symptoms) Also, at least they did put numbers on it ie, for every 161 persons treated with herceptin you may have had brain mets which otherwise would not have occurred if herceptin had not been given and although every 14th patient treated may have gotten symptomatic heart failure that they otherwise might not have had, you had to treat 64 to get asymtomatic heart toxicity (which by other reports is treatable and reversible) Perhaps better some numbers than no numbers (and only one's imagination which is usually worse! ) "The DFS, DDFS, and OS were significantly better in the T-arm, with an AD of 6.00, 4.80 and 1.96%, which translates into 16, 21 and 51 NNT respectively"--This means they only had to treat 16 patients for two years to show an improvement in disease free survival in one, 21 patients for two years to see increased distant disease free survival ie, mets, in one and 51 patients to see an increased overall survival, as I understand it. Hopefully as results mature with longer follow-up of patients the benefit wil show itself even more strikingly. Their Conclusion was: The overall outcome results show that trastuzumab is one of the most important discoveries in oncology. But they hedged and said we need to understand how it works better in order to decrease side effects so that the risk/benefit ratio is even more impressive. Hope this helped.