Dear Vicki,
I want to congratuate you with respect to your near completion of chemo and welcome you to the group, albeit under difficult circumstances.
I have provided you with a cross-link link below to a list of clinical trials obtained at
www.clinicaltrials.gov with the search terms "Herceptin, Stage I." My review of the list indicates that the first three clinical trials apply to Stage I patients. Unfortunately, the first trial (known as HERA) is conducted outside the U.S. and, to my knowledge, does not accept U.S. citizens as patients. The second two trials listed include UCLA as a location; however, it appears that you would not qualify for either due to prior use of breast cancer chemotherapy. In any event, I would still contact UCLA with the facts of your case to see if you qualify.
You can look into HER-2 vaccine programs, however, I believe that most programs do not accept Stage I patients. Just in case, you may want to contact Andrea York at the University of Washington (see contact number on clinical trial message board) to see if you could qualify. You can search
www.clinicaltrials.gov for other vaccine programs with search terms such as "breast cancer, vaccine."
The technical answer to your questions regarding the effectiveness of herceptin in an adjuvant setting is as of yet unknown. There are on-going herceptin adjuvant clinical trials but these studies have published no results as of yet. Please be aware that Herceptin has been used in clinical trials in a neoadjuvant (pre-surgery) setting and the results were somewhat similiar to the results found in Stage IV use of the drug. Many patients feel, based upon anecdotal evidence, that herceptin may prove more effective if used prior to Stage IV when the tumor burden to the body is much less. It appears that you may want to contact the doctor referenced in your post and determine whether that doctor is willing to put you on herceptin in a non-clinical trial setting (generally referred to as "off-label" or "off-protocol" use).
Herceptin has been used (generally in combination with chemotherapeutic agents such as Taxol, Taxotere or Navelbine, with or without platinum salts such as Cisplatin or Carboplatin) for bone, lung and liver mets and such drug "cocktails" have been found effective. Herceptin can not penetrate the blood-brain barrier (BBB) and is generally not effective in treating brain mets. Many patients who have had whole brain radiation (WBR) in connection with brain mets feel that WBR may breach the BBB and allow herceptin to reach the brain in some quantity. This evidence is anecdotal as well.
The term "NED" stands for "no evidence of disease." It is a term most often used in Stage IV to indicate that generally-used diagnostic tests (e.g., CT scan, PET scan, MRI scan) can not detect the presence of cancer in the body after treatment for metastatic disease. Because cancer can exist at the cellular level without the presence of a solid tumor that is detectable, the term NED is used in lieu of the term "cure."
I hope this information is helpful.
Warmest regards,
Paul