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Becky · 04-26-2006, 05:19 PM

An anthracyline like adriamycin or epirubicin had always been used for all Her2+ women in the past because studies had shown there was better survival in Her2+ women if one was used. What they didn't know was that 50% of Her2+ women are also Top 2A positive as well. Top 2A overexpressed responds extremely well to an anthracyline chemo agent. So well in fact that Dr. Slahom has stated that a Her2+ woman should be tested for Top 2A and if positive, would only need AC or EC treatment and no Herceptin (regardless of node status). Otherwise, it would be best to use Carboplatin/Taxol (or Taxotere)/Herceptin. Either of these would be easier on the heart than what they do now.

The Top 2A finding and an easier to find lab test is a very relatively new finding. Secondly, until 10 months ago, an early stage Her2+ woman could not secure Herceptin. Because of that, it was prudent to have adriamycin or epirubicin because it is effective for Her2+ disease.

However, the trial results show that carbo/taxol/herceptin does reduce recurrence rate by 39% over AC followed by T without added Herceptin. None of this is dense dose. With AC followed by TH, the reduction is 52% - really not much of a difference but is probably explained by the Top 2A factor.

If you are concerned, you can take Christine's excellent suggestion and get Top 2A tested. If you are overexpressed. You can finish your current rounds and stop Herceptin and take adriamycin instead.

Otherwise, the treatment you are on is totally appropriate and Herceptin is a life saving drug.

Kindest regards

Becky

04-26-2006, 05:19 PM	#7
Becky Senior Member Join Date: Sep 2005 Location: Stockton, NJ Posts: 4,179	An anthracyline like adriamycin or epirubicin had always been used for all Her2+ women in the past because studies had shown there was better survival in Her2+ women if one was used. What they didn't know was that 50% of Her2+ women are also Top 2A positive as well. Top 2A overexpressed responds extremely well to an anthracyline chemo agent. So well in fact that Dr. Slahom has stated that a Her2+ woman should be tested for Top 2A and if positive, would only need AC or EC treatment and no Herceptin (regardless of node status). Otherwise, it would be best to use Carboplatin/Taxol (or Taxotere)/Herceptin. Either of these would be easier on the heart than what they do now. The Top 2A finding and an easier to find lab test is a very relatively new finding. Secondly, until 10 months ago, an early stage Her2+ woman could not secure Herceptin. Because of that, it was prudent to have adriamycin or epirubicin because it is effective for Her2+ disease. However, the trial results show that carbo/taxol/herceptin does reduce recurrence rate by 39% over AC followed by T without added Herceptin. None of this is dense dose. With AC followed by TH, the reduction is 52% - really not much of a difference but is probably explained by the Top 2A factor. If you are concerned, you can take Christine's excellent suggestion and get Top 2A tested. If you are overexpressed. You can finish your current rounds and stop Herceptin and take adriamycin instead. Otherwise, the treatment you are on is totally appropriate and Herceptin is a life saving drug. Kindest regards Becky Last edited by Becky; 04-26-2006 at 05:21 PM..