HER2 Support Group Forums - View Single Post - the REALLY REALLY good news and the bad news (her2 stats outside clinical trials)

Lani · 08-11-2012, 01:29 PM

from the paper:
"The limitations of our study include a short follow-up (median of 2 years), but the 2-year point was when most of the adjuvant trastuzumab trials were first reported"
Median length of follow-up was 2.1 years and graphs in the article go out to 3 years.

Since historically according to Dr. Slamon her2+ breast cancers recurred prior to the time that the average of all types of bc recurred, good results @ 3 years would imply continued good results.

So far the No. American and HERA trials have not shown reversal of improved outlook of patients treated with herceptin ie, it is not just that they take longer to recur, so far they just do not recur) so it looks like the graphs which look great @ 3 years should continue to do so

THis study was somewhat confounded by adressing those who were offered herceptin late (WHENEVER after ASCO 2005 BRITISH COLUMBIA BEGAN TO OFFER THOSE WHO DID NOT GET IT A CHANCE TO GET IT) AND ONLY 28% OF THOSE WHO DID NOT GET HERCEPTIN EVEN GOT CHEMOTHERAPY!!!????

JUST SHOWS YOU HAVE TO READ THE SMALL PRINT AND NOT JUST THE ABSTRACT BEFORE CITING STUDIES AND ACCEPTING THEIR STATS AS THOSE THAT SHOULD BE DISSSEMINATED.

BUT I THINK THE TWO TAKE-HOME MESSAGES I IMPLIED PREVAIL"

1)THOSE WHO GET HERCEPTIN ADJUVANTLY STAGE 1-3 DO EXCEPTIONALLY WELL
CONSIDERING WHO THEY USED TO DO AND CONSIDERING THAT THEY NOW DO BETTER RATHER THAN WORSE THAN SOME OTHER SUBTYPES
2) THERE IS A CONCERN ABOUT HER2+ BREAST CANCER'S PREDELICTION FOR THE CNS AS A FIRST SITE OF METASTASIS, LACK OF GOOD SCREENING (PERHAPS FOLLOWING SERUM HER2 ECD IF IT WOULD BE FOUND TO BE SENSITIVE AND SPECIFIC ENOUGH TO HELP IN THIS REGARD OR SOME OTHER TEST AND GETTING BRAIN IMAGING IF IT INCREASES--SEEMS LIKE THE ACTUAL NUMBER OF THOSE GETTING HER2+ BRAIN METS AS FIRST SITE OF METASTASIS ALTHOUGH LARGER THAN PREVIOUSLY THOUGHT IS STILL SMALL WHEN YOU CONSIDER THE RESOURCES NECESSARY TO FOLLOW THEM WITH BRAIN IMAGING (AND WE DON'T EVEN REALLY KNOW HOW OFTEN).
THE PERCENT OF THOSE WITH BRAIN METS AS FIRST SITE OF METASTASIS IS CONSIDERABLE IN THOSE TREATED WITH HERCEPTIN SO LOOKING FOR WAYS TO DETECT THEM EARLY WHILE THEY ARE TREATABLE BY CYBER OR GAMMA KNIFE IS IMPERATIVE IT WOULD SEEM.

08-11-2012, 01:29 PM	#3
Lani Senior Member Join Date: Mar 2006 Posts: 4,778	Re: the REALLY REALLY good news and the bad news (her2 stats outside clinical trials) from the paper: "The limitations of our study include a short follow-up (median of 2 years), but the 2-year point was when most of the adjuvant trastuzumab trials were first reported" Median length of follow-up was 2.1 years and graphs in the article go out to 3 years. Since historically according to Dr. Slamon her2+ breast cancers recurred prior to the time that the average of all types of bc recurred, good results @ 3 years would imply continued good results. So far the No. American and HERA trials have not shown reversal of improved outlook of patients treated with herceptin ie, it is not just that they take longer to recur, so far they just do not recur) so it looks like the graphs which look great @ 3 years should continue to do so THis study was somewhat confounded by adressing those who were offered herceptin late (WHENEVER after ASCO 2005 BRITISH COLUMBIA BEGAN TO OFFER THOSE WHO DID NOT GET IT A CHANCE TO GET IT) AND ONLY 28% OF THOSE WHO DID NOT GET HERCEPTIN EVEN GOT CHEMOTHERAPY!!!???? JUST SHOWS YOU HAVE TO READ THE SMALL PRINT AND NOT JUST THE ABSTRACT BEFORE CITING STUDIES AND ACCEPTING THEIR STATS AS THOSE THAT SHOULD BE DISSSEMINATED. BUT I THINK THE TWO TAKE-HOME MESSAGES I IMPLIED PREVAIL" 1)THOSE WHO GET HERCEPTIN ADJUVANTLY STAGE 1-3 DO EXCEPTIONALLY WELL CONSIDERING WHO THEY USED TO DO AND CONSIDERING THAT THEY NOW DO BETTER RATHER THAN WORSE THAN SOME OTHER SUBTYPES 2) THERE IS A CONCERN ABOUT HER2+ BREAST CANCER'S PREDELICTION FOR THE CNS AS A FIRST SITE OF METASTASIS, LACK OF GOOD SCREENING (PERHAPS FOLLOWING SERUM HER2 ECD IF IT WOULD BE FOUND TO BE SENSITIVE AND SPECIFIC ENOUGH TO HELP IN THIS REGARD OR SOME OTHER TEST AND GETTING BRAIN IMAGING IF IT INCREASES--SEEMS LIKE THE ACTUAL NUMBER OF THOSE GETTING HER2+ BRAIN METS AS FIRST SITE OF METASTASIS ALTHOUGH LARGER THAN PREVIOUSLY THOUGHT IS STILL SMALL WHEN YOU CONSIDER THE RESOURCES NECESSARY TO FOLLOW THEM WITH BRAIN IMAGING (AND WE DON'T EVEN REALLY KNOW HOW OFTEN). THE PERCENT OF THOSE WITH BRAIN METS AS FIRST SITE OF METASTASIS IS CONSIDERABLE IN THOSE TREATED WITH HERCEPTIN SO LOOKING FOR WAYS TO DETECT THEM EARLY WHILE THEY ARE TREATABLE BY CYBER OR GAMMA KNIFE IS IMPERATIVE IT WOULD SEEM.