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Lani said: TO ME THAT MEANS IT IS A PREDICTOR OF HOW WELL HERCEPTIN MAY WORK, which may reflect both inherent efficacy ie, lack of inherent resistance.
I didn't say there was no value to the test. It's a tumor marker, basically, and when a tumor marker accurately reflects amount of disease (which they do for some but not all breast cancer), they are useful to monitor metastatic disease and treatment of same. I hope that for HER2+ disease, they will be a more reliable tumor marker to help tailor treatment of metastatic disease.
However, I see nothing in the studies to support your original subject line about serum HER2 ECD testing before and after primary surgery being predictive of response to Herceptin. Yes, there's going to be a drop in serum HER2 ECD (if it was even elevated, which it isn't always) after surgery which removes the cancer (there had BETTER be a drop). But that doesn't tell us anything about Herceptin's efficacy.
There are studies of neoadjuvant Herceptin. If those used serum HER2 ECD, then we'd have some information, perhaps. But there are other ways to assess efficacy in that situation and serum HER2 ECD would have to show that it's easier, more accurate, or cheaper - which it may well be. I imagine that those studies are in progress.
I don't see that much on this list - neoadjuvant treatment. Who here has had neoadjuvant Herceptin?
I wish that there were something that could tell us, as Dianne wishes, that ADJUVANT treatment (all of it, not just Herceptin) is working but I do not think that we have that. Each time we find a more targeted treatment, like hormonal treatment, and Herceptin, and probably Tykerb, we get closer to knowing something is working. But we're not there yet.
Good discussion. Thanks, again, Lani - for taking the time. You are making a big difference to the lives of many people.
Debbie Laxague
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