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Interesting discussion! And even when we're not sure we're talking about the same thing, it turns out that we are.
I agree with you, Jean. It seemed like a big deal to figure out HER2 but now we see that might be just the tip of the iceberg.
And now I understand, and agree with, your question about duration related to subtypes. The biggest part of that question to me is to ask whether it might it be important that hormonal treatment for triple positives be accompanied by some sort of Herceptin (or other anti-HER2) for the duration of the hormone treatment? There have been suggestions that treating HER2 might reverse or control resistance to hormonal treatment. Perhaps it would turn out to be not even the same Herceptin dose/interval as is used for adjuvant treatment. Or maybe one of the other, newer, targeted treatments would be a better match. I know there are studies looking at hormonals+targeted agents of various kinds, in metastatic disease (and not just HER2+ disease).
Again, the adjuvant Herceptin trials were not designed to look at all these nuances (at least I don't think that they were). But they did track these things (ERPR positivity, etc) so even a retrospective look back at these subtypes will be of some use. It could at least clarify what the questions ARE that need to be asked. I hope that we start hearing these results soon.
Debbie Laxague
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