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Jean, I didn't understand what you were asking at first (and I'm still not entirely sure that I understand).
I'm hearing two questions here. If Herceptin is being given to control mets, then half-life has relevance. But I don't think that's what you're asking.
If Herceptin is given adjuvantly, it is my understanding that it's like chemo - the goal is to eradicate completely any stray cancer cells and "cure" the person of the cancer, during that time of administration. Of course the rub is that there's no way to know who those cured people are. But the theory as I understand it is that those who are not cured will recur at some point and then the game shifts to control rather than total eradication which may be possible with adjuvant treatment (which is not to say that there won't appear to be total eradication for long periods of time).
So half-life of Herceptin for adjuvant treatment isn't relevant. What IS relevant, and we do not know the answer yet, is how long to give Herceptin for best results. A small trial with a very short duration (six weeks?) appeared to do as well as the more-studied one-year duration (but it was not a head-to-head as far as chemo regimen, etc, and it was a small trial). But still, the results were as impressive as the one-year results were. Now there's at least one active trial looking at duration - one year vs. two years. I don't think we have any results yet, though.
Can you say more about your question? I'm still not clear. (And triple negative can't BE positive for ER and would not get Herceptin because HER2 is one of the negatives also.)
Again, being somewhat unsure what you're asking, I'm not sure if what I'm saying is even on-topic. I think that there is increasing interest (research) about triple positives (ERPR+ and HER2+) because there appear to be a subset (probably the highly ERPR+'s) in there who do very well and do not seem to have the typical HER2+ worse-prognosis. In addition, they need to figure out the best way to combine Herceptin (or other anti-HER2 treatment) with hormonal treatment for those who are less ERPR+ and/or are in the worse-prognosis group. But it seems like we're just beginning to hear these questions. I hope that all the adjuvant Herceptin trials that have already reported will begin sorting thru such details and at least clarifying what questions we should be asking.
Phew. Sorry - once I get started asking questions it's hard to reign the thoughts back in.
Debbie Laxague
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