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vI believe the FinHer study was small yet large enough with over 200 people in the study to draw statistical significance. In other words the results are not random. Further, if you study the FinHer data, you will find that the study group or the group that got Herceptin had more disease than the control group who did not get Herceptin. Yet, interestingly, the study group had longer disease free survival than the control group. Obviously something caused these miraculous results in the study group and it's called adjuvant Herceptin.
Interestingly, the cardiac status was preserved with only 9 weeks of Herceptin in a THREE YEAR follow-up. To me this suggests that less is best, particularly when it is given before cardiotoxic chemotherapy such as AC or anthracylcines. As you may or may not know, the NEJM presented an article that suggests that anthracyclines sensitizes the heart for damage and Herceptin stimulates the damage by interfering with alternative pathways via the kinases. In other words, if you get AC treatment, get it following Herceptin, not prior to prevent cardiac damage.
In the early days of adjuvant chemo, it was used for a year or more. Now it is only used for several months for the same efficacy. I believe that further adjuvant Herceptin studies will also develop a trend for shorter therapy with less toxic burdens financially and physically.
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