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Old 03-14-2007, 08:38 AM   #1
Marlys
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Becky, What does this mean?

I received this from Therapeutics Weekly and am wondering what the meaning is:

Research from University of Texas, M. D. Anderson Cancer Center Provide New Insights Into Breast Cancer Therapy
Cancer Weekly - Mar. 13, 2007
Researchers detail in "Lapatinib induces apoptosis in trastuzumab-resistant breast cancer cells: effects on insulin-like growth factor I signaling," new data in breast cancer. According to a study from the United States, "The majority of breast cancer patients who achieve an initial therapeutic response to the HER2-targeted antibody trastuzumab will show disease progression within 1 year. Thus, the identification of novel agents that effectively inhibit survival of cancer cells that have progressed on trastuzumab is critical." <O"In the current study, we show that the dual epidermal growth factor receptor (EGFR)/human EGFR-2 (HER2) kinase inhibitor lapatinib induces apoptosis in trastuzumab-resistant cells derived from the HER2-overexpressing SKBR3 breast cancer line. Lapatinib inhibited EGFR and HER2 signaling in resistant cells, blocking activation of downstream Akt, mitogen-activated protein kinase, and S6 kinases and inducing expression of p27kip1. Importantly, lapatinib also inhibited insulin-like growth factor I (IGF-I) signaling and growth-promoting effects in parental and resistant cells, and the cytotoxic effects of lapatinib were further enhanced by the IGF-I receptor-blocking antibody alphaIR3," wrote R. Nahta and colleagues, University of Texas, M. D. Anderson Cancer Center. <OThe researchers concluded: "As increased IGF-I receptor signaling has been implicated in trastuzumab resistance, our data strongly support further study of lapatinib as a potential therapeutic in breast cancers that have progressed on trastuzumab."Nahta and colleagues published the results of their research in Molecular Cancer Therapeutics (Lapatinib induces apoptosis in trastuzumab-resistant breast cancer cells: effects on insulin-like growth factor I signaling. <O
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Old 03-14-2007, 09:52 AM   #2
betlen5
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I was told that Herceptin will only last about 9 months after taken with Taxol. 9 months later it has returned? Why don't they tell you this information before receiving the treatment?
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1/2002 DX stage IIa IDC er/pr+ her2 3+ positive: insitu ductal carcinoma right breast, 3cm 8 node removal all neg;lumpectomy;4 rounds A/C; 33 rads
tamoxifen
4/2004 DX Local Reacurrance; er/pr+ her2 3+ positive; nodes 9 of 12 positive largest 1.5 cm; 28 rads;stopped tamoxifen;went on Femara/lupron
8/2004 DX Local Reacurrance; er/pr+ her2 3+ positive; dbl mas reconstructive surgery w/tran flap; no chemo or drugs
11/2005 DX Local Reacurrance; er/pr+ her2 3+ positive; Taxol/Herceptin 1x weekly for 12 weeks; Herceptin for 9 months 1x 21 days
12/2006 DX Local Reacurrance; er/pr- her2 3+ positive; Her 2 rechecked with FISH her2+++ er/pr-
3/9/07 Started Tykerb (Lapatinib) 1250 mg/once daily
Xeloda (Capecitabine 2000 mg/m2/daily 1-14 every 21 days
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Old 03-14-2007, 03:46 PM   #3
Barbara2
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Is it in reference to metestatic breast cancer?

The sentence that you highlighted in red, is one that I also have highlighted (from the "volumes" of information that I make copies of) from an article with the same quote, some time ago. I wondered what that meant, too. Is this statement referring to metestatic breast cancer?
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DX Oct 02 @ age 52 Stage 2B Grade 3 Mastectomy
"at least" 4.5 cm IDC 1+node ER+61% /PR-
Assiciated Intraductual component with Comedo Necrosis
Her2+ FISH8.6 IHC 2+
5 1/2 CEF Arimidex
Celebrex 400mg daily for 13 months
Prophylactic mastectomy
Estradiol #: 13
PTEN positive, "late" Herceptin (26 months after chemo)
Oct 05: Actonel for osteopenia from Arimidex.
May 08: Replaced Actonel with Zometa . Taking every 6
months.

Accepting the gift of life, I give thanks for it and live it in fullness.
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Old 03-14-2007, 06:52 PM   #4
Jean
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Becky,

is out of town on business and will return at end of week.
She does not have access to computer.

Jean
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Stage 1, Grade 1, 3/30/05
Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
Herceptin 5/06 - for 1 yr.
9/06 Completed chemo
Started Femara Sept. 2006
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Old 03-14-2007, 07:32 PM   #5
Hopeful
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Maryls,

Here is a link to a recent article which states that Herceptin is cost effective, given the improved survival time of patients: http://www.medscape.com/viewarticle/553595

Here is a pertinent excerpt:

The 2 studies differed in 2 key areas — the duration of trastuzumab's benefit<sup> </sup>and the annual risk for systemic recurrence. In the study led by Nicola Lucio Liberato, MD, from the Azienda Ospedaliera della Provincia di Pavia, Ospedale Civile, Italy, they assumed that the benefit of trastuzumab would persist<sup> </sup>only for 5 years — a notion that is well supported by the Early Breast Cancer<sup> </sup>Trialists' Meta-Analysis.

In contrast, in the study led by Allison Kurian, MD, from the Veterans' Affairs Palo Alto Health Care System and Center for Primary Care and Outcomes Research at Stanford University, in California, they assumed a one-third decline in benefit in years 3 to 5 and<sup> </sup>an additional but persistent benefit from years 6 to 10. In their editorial, Drs. Hillner and Smith call these numbers "excessively optimistic." The reports also differed slightly<sup> </sup>in the risk for systemic recurrences beyond 5 years, but this<sup> </sup>had little impact on the results.

Hope this information is useful.

Hopeful<sup> </sup>
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Old 03-14-2007, 08:04 PM   #6
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I guess if I had stopped to really think this out I would have realized that it probably is not referring to those of us who were stage 1 who received Herceptin after the 2005 ASCO released the news about the trials. Mainly because no one is following up on us as if we were in a trial. I will continue with my head in the clouds and my ears to the ground until my body tells me otherwise. Hopeful, thanks for your input. I subscribe to Medscape for Nurses as I am one(old & retired but they don't care.)
Love & hugs,
Marlys
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