HER2 Support Group Forums - View Single Post - putting risk of brain mets as first evidence of recurrence in perspective

Lani · 05-27-2006, 08:12 AM

I haven't had a lot of time in the last few days, but I did get the original article and found it used IHC but not with the DAKO test. No FISH was done. As with many studies out of Europe UNTIL RECENTLY, they did not treat anyone with very small tumors at all(systemically, anyway) and ER+ node negative tumors only got tamoxifen(or more recently an AI). I did see from a quick look at the table that tumors were both ER+ and ER-. I did not look to see if they counted microinvasion as "tumor" Will try to get around to studying it further, but I did not feel this article was the DEFINITIVE one or I would not have added " they FELT" to my post.

Also patients in the clinical trials are a distinct population--they disqualify people in the wrong age group (too old), with other diseases, they test her2 centrally (or at least in labs with better accuracy), and they try to make sure certain characteristics are fulfilled (US studies node positive generally, HERA both + and -). And the type of patients who participate in clinical studies are more compliant (only 50% OF PATIENTS DO ACTUALLY TAKE THEIR ANTIHORMONALS IT HAS BEEN ESTIMATED) THESE ARE BUT A FEW OF THE DIFFERENCES OF THE PATIENT POPULATION SO COMPARISONS ACROSS STUDIES IS FRAUGHT WITH DANGER. THERE WAS A LOT OF CRITICISM EVEN THAT THE TWO US ADJUVANT HERCEPTIN STUDIES WERE COMBINED!

HOPE THIS HELPS!

05-27-2006, 08:12 AM	#4
Lani Senior Member Join Date: Mar 2006 Posts: 4,778	RB you are reading too much into this it seems ( I think) I haven't had a lot of time in the last few days, but I did get the original article and found it used IHC but not with the DAKO test. No FISH was done. As with many studies out of Europe UNTIL RECENTLY, they did not treat anyone with very small tumors at all(systemically, anyway) and ER+ node negative tumors only got tamoxifen(or more recently an AI). I did see from a quick look at the table that tumors were both ER+ and ER-. I did not look to see if they counted microinvasion as "tumor" Will try to get around to studying it further, but I did not feel this article was the DEFINITIVE one or I would not have added " they FELT" to my post. Also patients in the clinical trials are a distinct population--they disqualify people in the wrong age group (too old), with other diseases, they test her2 centrally (or at least in labs with better accuracy), and they try to make sure certain characteristics are fulfilled (US studies node positive generally, HERA both + and -). And the type of patients who participate in clinical studies are more compliant (only 50% OF PATIENTS DO ACTUALLY TAKE THEIR ANTIHORMONALS IT HAS BEEN ESTIMATED) THESE ARE BUT A FEW OF THE DIFFERENCES OF THE PATIENT POPULATION SO COMPARISONS ACROSS STUDIES IS FRAUGHT WITH DANGER. THERE WAS A LOT OF CRITICISM EVEN THAT THE TWO US ADJUVANT HERCEPTIN STUDIES WERE COMBINED! HOPE THIS HELPS!