[RobinP]

For those who are on Herceptin now who are not stage 4, I agree with Al that Herceptin has got to stop at some point. I would assume that would be one to two years of therapy. Certainly, even with less therapy than that may be appropriate as the FinHer trail, of 9 weeks of Herceptin, was just as effective as one year of Herceptin. I really think what we'll see is a trend toward shorter Herceptin therapy; particularly to avoid cardiac side effects as the 9 weeks of Herceptin had zero cardiac risk.

I don't think prolonged Herceptin therapy prevents Herceptin resistance. As others here have mentioned, if you possess certain markers, you may become Herceptin resistant. I think we have an idea of what some of those markers may be pre-clinically, pTEN deficiency, perhaps high IGF and perhaps high Her3. However, researchers need to define if pre-clinical markers translate into the human experience. Hopefully, we will have a lot of answers to the significance of markers like pTEN from the HERA trail, should the investigators re-examine the tissue blocks from the trail participants. . Once this is determined then perhaps drugs like Lapatinib, IGF inhibitors, her3 inhibitors will be used in the mix with Herceptin in the adjuvant setting. However, many of these drugs are only available to the mets population now, and only in clinical trails.


I look forward to what the HERA trail investigators will find in the bc tissue blocks. I bet a lot of the Herceptin responders were positive not only for her2 but for her1 and 3 too. Anyway, what is her2 without its partners in crime; its not like her2 does its jaded act in solo.