[RobinP]

Al, I did have Dr. Bacus, a pathologist from TMD lab, help me select my tests after I told her what I was looking for, that is whether I would respond to Herceptin or Lapatinib or both. I agree with your repetoir of markers to be tested for targetted drugs and chemotherapy and suspect it will be standard of care in the future. P53 mutations often confers to chemotherapy resistance and Taxol is the most effective chemotherapy in this case.Cmyc is often resistent to chemotherapies as well; however, I haven't seen much research on Cmyc. I agree that TOPO2 expression correlates with anthracycline use. And PI3k levels correlates with pTEN levels, and IGF levels and perhaps with partial decreases in Herceptin responsiveness as Herceptin's impact on PI3K is only one of its pathways for decreased proliferation, the other being downreguation of her2 itself. As for VEGF and COx2, I think they are going to be ignored as markers for as Avastin never met its primarily endpoint, disease reduction in mets bc. unless detected early enough and Cox2 inhibitors, at least in theory may decrease angiogensis but I haven't seen many studies on it, particularly in the mets population.

Michelle, I haven't commented on lab core because I don't know a thing about it. I used TMD lab.