Progression free survival vs overall survival

[Sheila]

I had a lengthy talk with my oncologist yesterday....we were discussing Avastin in particular, and that many of the new targeted agents measure progression free survival, but do not lengthen overall survival. She is a professor of oncology, one of the first in the US to give Herceptin and chairs the Brian Piccolo Foundation...her explanation was simple...in breast cancer, we are fortunate that as soon as progression occurs while on a drug, there is something newer or another drug to try....so drugs are measured on progression free survival rather than overall survival...most can't give this measurement as we are on them so long and then build resistance and progress...off to a new combo, a continual circle. But in this circle, many are surviving even as stage IV patients for many years...15-20 or longer. She pointed out that this is not the case in pancreatic cancers and primary lung cancers....drugs are more limited, and these tumors are so virulent that as soon as one progresses, it is most likely too late for a new med. She also mentioned that although they have seen a great reponse with Avastin at reducing tumors, it is coming at a price of more cardiac complications than were thought. Her consensus was that it may not be FDA approved in February, due to the high incidence or unmentioned complications being seen in women. Time will tell. I do know that in being off it one month, my nodes in my neck HAVE NOT increased in size, and my systolic B/P has dropped 30 points, dyastolic 20 points.....I am still on meds though for the B/P .

[Jean]

Hi Shiela,
I am glad to hear that those nodes are behaving....also that your BP is
going down....I am praying that your BP continues to go down and your nodes remain silent.

Sending you a huge hug,
Jean

[IRENE FROM TAMPA]

Your post says that you are off of the Avastin now. What are you presently taking and what mets are you treating?

I am starting my first treatment of HERCEPTIN/AVASTIN/TAXOTERE today. Meantime, I am continuing my search of other drugs just in case this does not work on me.

I hope they will give to me as I am having a low grade fever from my sinus' and my throat is very scratchy. This is not unusual for me this time of year but feel like crap.

Hope your holiday was a good one despite everything else and you are feeling well.

[Sheila]

Irene
I am still on Herceptin and Taxol...Herceptin 4+ years now and Taxol 7 months....I have been off Avastin 2 treatments or 1 month...so far so good. My insurance company denied payment on it due to the ruling, but considering my high B/P even with medication, (I have always run very low my whole life until Avastin) it was probably time. Please do keep a check on your B/P, many of us have to take meds for it with the Avastin...mine did fine at first, then slowly started creeping up higher and higher, then cam e meds, and it continued to rise! Good luck with the new combo...other than the B/P, I felt it was easy to tolerate!

[IRENE FROM TAMPA]

I have been taking Avastin since Sept with the Tykerb, but since I now progressed to two "more" tumors he thought time for change.

I am on B/P meds since Oct. so far seems to keep it a bit lower. I always ran normal also but went up to around 139/89 where it seems to stay although last weeks reading was 114/78????? Thas was unusual even for me.

Do you think that the Avastin along with the Herceptin could cause added b/p issues? I was on Herceptin for 6 1/2 years some time back and I did notice that my pressure always ran a little higher then norm for me. Other then that, everything else was fine with my muga scans.

I guess I will see how I do. Its has been a few years now since I have tried the Herceptin.

Thanks Sheils

[Sheila]

Irene
I think I forgot to mention my mets are in my lymph nodes in the neck area...just like Lolly....my B/P has always been 110/60....even with Herceptin, but it kept climbing since the Avastin and was running 180/88 even with meds....I could feel it going up...anyway, after being off 1 month it is 145/78 with meds, so maybe it was the combo with the Herceptin and Avastin....I am just glad its going down!

[StephN]

Hi Girls -
My friend here took Avastin with Abraxane (NO Herceptin). Her blood pressure skyrocketed before it was over. She took this combo for about 3 or so months. Stopped the Avastin first, then the Abraxane.

She reported last week that she is now OFF the blood pressure meds after stopping the Avastin a little over a year ago. So, this does seem to self correct with time as can the LVF drop from Herceptin. Her underarm nodes are also still under control. So, I hope that is a good omen for you, Sheila.

[Faith in Him]

Shelia,

Thank you for sharing that. It is such encouraging news. I have been a little down lately but after reading your post, I feel my I can do this attitude coming back.

[Bill]

Hi Sheila, sounds like good news. Thinking of you and praying for you. Love, Bill

[hutchibk]

Thanks to you and your doc for the explaination, Sheila. I always enjoy 'long talks with the onc' - whether it's mine or someone elses...

[Joanne S]

Thanks for sharing Shiela.

Seeing there is so many diffent kinds of breast cancer, grades, stages,etc., I sometimes wonder how they can accurately measure and compare progression/disease free survival versus overall survival?

Although not scientific, it just seems logical to me that if one has progression/disease free survival, it would extend one's overall survival.

If there is no difference in overall survival, why is it that so many on this site are living many years with treatment of recurrences?

If treatment of recurrences does not lengthen survival time, then why go through the trouble and side effects of treatment after diagnosis of recurrence (expecially if the recurrence does not cause any physical symptoms)? Perhaps that's why my oncologist is not keen on post- therapy monitoring/follow-up scans/tests.

What do you think? I truly get more value from all the input on this site than I get anywhere else. Thank you all!