ASCO - Herceptin

So, having listened to the ASCO presentations from yesterday re. trial results (thanks Joe for posting easy to use link), it sounds as if while there is an advantage to Herceptin taken sequentially, the huge advantage is to take it concurrently with chemo (Taxol in the case of the trials). I'm getting it now, having been on the control arm of the trial. Glad I'm getting it, but of course wish even a little more than before that I had landed the concurrent arm of trial. Still, every trial needs the control arm. And there does seem to be a benefit to getting it sequentially (13% I think they said), although I assume they will do more analysis of those who got it right after Taxol, and those who get it within the 6 months after finishing. What a lot of news this week - heading in the right direction anyway!

I haven't yet listened to the presentations (am at work right now), but it's interesting that they are reporting only 13% benefit for sequential use of herceptin. I wonder if they perhaps meant ABSOLUTE rather than relative benefit? -- because, of course, HERA (where all subjects were given heceptin AFTER chemo) reported a 46% benefit for those who received herceptin.

Regards,

/Christine

My understanding of ASCO presentation is
AC->Taxol->Herceptin prevents recurrence by 46%
AC->Taxol+Herceptin prevents recurrence by 52% where as
AC->Taxol prevents recurrence by 33%

Can somebody comment whether it is correct or not.

Thanks
Julie

And of course you have to discount my complete lack of statistical skill - relative and absolute are concepts I never really grasped!

Missing from all these stats is breakdown by age, node ststus and hormone receptor status.

Ladies ,
Thank you for your post. I was wondering what the exact numbers were. They mean that you have a 13% additional chance of being cured taking Herceptin after chemo, where as you have you have 19% additional chance with the chemo+Herceptin. The difference is 6%. I don't know if it is a lot or not. Do you think it is worth it for someone to go back on chemo+ Herceptin if they are doing the Herceptin only? That is a very rigourous arm. This lady we know had to go to 3 week tx's because she couldn't handle the mx pain and discomfort. Anyone had minimal side effects with the combo?

Anne

[Rozebud]

Actually, the differences by age, node status, tumor size, etc. were included in the slides by Edward Romond. However, I don't know what a hazard ratio is?? Can someone who is good at stats help us intepret?

[michele u]

Rose,
I'm a nurse and i don't have a clue what all those terms mean!! Maybe someone could research it for us. Hazard results, p values, disease free survival compared to overall survival, incidents? All that makes no sense to most of us.

So right ladies! I am new to all this and just now catching on a little... maybe we need an interpreter?

I am curious also as to how the ER/PR status' were figured in?

Marcia

[Rozebud]

Marcia - it did show ER/PR status too....age, ER/PR, # of nodes, age, and size of primary tumor. I think that was it. It showed the delta in the hazard ratio. The key takeaway is that ALL groups benefited, but to see if some were better than others, we need a "hazard ratio" interpretation.

Maybe I'll do some research!

Michelle - I do know what p values and T scores are from graduate stats class. Essentially they help you determine the probability, in this case, that the decrease in recurrance and increase in survival is due to herceptin, vs. another outside factor. Anything less than .02 is good. In the first presentation, he said that the p ratio was so small that it had as many 0's as the world poputation!! So--> .00000000001 or something like that (to the negative 12th power). That virtually guarantees that the results we saw were due to herceptin.