[al from Canada]

Dear Kristin and Lolly,

Here is the conclusion to a fairly lengthy study suggesting that in ER+, HER2+ disease, suggesting that herceptin + AI (combination) therapy may be provide additional clinical benefit.
Take care,
Al




"Conclusions

In conclusion, the evidence that HER2 overexpression is correlated with poor clinical outcome, the existence of cross-talk between the HER2 and ER signalling pathways in breast cancer, and the lack of benefit achieved with hormonal therapy in patients with ER-positive/HER2-positive disease, and hence the fact that these patients are receiving sub-optimal treatment, suggest that combining treatments that target these different pathways may provide additional clinical benefits for patients with breast cancer. Trastuzumab has produced significant survival improvements in combination with chemotherapy in the first-line treatment of HER2-positive metastatic breast cancer and has also shown activity as a single agent as first- or second-line therapy. Tamoxifen has been shown to produce clear benefits in terms of survival and prevention of recurrence for both premenopausal and postmenopausal women with ER-positive breast cancer. Recent studies of aromatase inhibitors have demonstrated superior objective responses in comparison with tamoxifen. Taken together the evidence suggests that targeted non-chemotherapeutic combinations of trastuzumab with hormonal therapy, which are currently being studied in large-scale clinical trials, represent the future of cancer therapy, allowing the individualisation of treatment based on tumour characteristics."