Lani

What a stupid study--they compared apples with oranges!!!!Her+ breast cancer is one entity, her2- is another. They have different genes expressed/repressed, different behaviors, respond to different treatments.

It does point out, although it is poorly planned and executed, what we are happily finding out. That in the age of Herceptin, being her2+ may no longer be such a terrible disadvantage and is turning out to be an advantage--targetted therapy, vaccine therapies, targetted imaging, good serum marker test...

What we can now see, is that the clinical researchers in the first and second-world countries of the world will now be unable (except perhaps in third world countries) to do trials for patients who are her2+ and metastatic without offering both arms herceptin as it has been shown to be beneficial and treating someone without it would be immoral. This is how progress gets slowed down. Should they develop further a multiERBB antibody agent like pertuzumab(which gets 3 erbb receptors I believe) or one which could engage all 4(may or may not be necessary as her2 has no known natural ligand) they can only test it with Herceptin. To give it without would deny the patient the best known treatment

Al, concerning the 20% figure
1) this was in a small number of patients so statistics can easily be "warped"

2) they may have received a lot of anthracyclines in their "pretreatment" ie, adjuvant treatment

3) they may have been old with preexisting heart problems

4) they may not have had the proper baseline muga before starting or not been followed closely enough and disqualified quickly enough

5) they may have not had the most up-to-date radiation therapy and had left sided breast cancer in which case the double/triple insult of anthracyclines(or other cardiotoxic chemos), radiation and herceptin caused their problems.

6) they may have had excitable Italian husbands that stressed them out!!!!

These are but a few of the possibilities. Let's see if we can get the whole article!

Lani