[phil]

herc/perj/taxotere is not a trial now, that was the trial that led to appr. for first -line tx. but makes sense to me to add tax. for a while to herc/perj. adds punch. a doc can do it "off label ', if ins will pay. if someone gets good response they could scale back tax. or d/c it. some pts like Darlene Gant get great response from just herc/ perj . but we dont know yet by tumor analysis which apparent subtype of her2 gets what response. so go more aggressive w/ a tax. if someone progresses on perj w/o a taxane or progr. on t dm-1 , i would look at adding tax. to herc/perj or using herc/tyk., if someone has hx of brain mets. or this farber trial that shuts off several pathways while delivering a doxil dose directly to mutated cells, as t dm-1 does . but tdm-1 only has HER2 pathway blocked. i want a system where stage ivs can try these combos of appr . drugs , like t dm-1 w/ tykerb. or having more flexible entry regs in phase III trials for drugs like the new t dm-1 style drug at farber , w/ Dr. Krop, described above . or this new er+ drug, pd03391 , that has shown great promise at phase II . phase II already involves yrs of safety , and dosing testing. from the Sacrifices in phase I of .... Stage IVs !!