Debbie,
Dr. Radvin made the following comments in a Breast Cancer Update issue in 2003:
"Impact of therapy on early versus late relapses
The divergence of curves with effective adjuvant therapy has not been adequately studied, and I think there is an enormous hidden story there. Some curves begin to diverge within the first year, continue to diverge for the first five years and then parallel each other. Curves like this tell me the therapy is killing the rapidly progressive, early relapsing clones.
The last overview showed that the proportional benefits for chemotherapy emerged entirely because of impact on relapses within the first five years.
There was no impact at all on relapse from the average chemotherapy after five years — a fascinating result. (emphasis added)
With chemotherapy, we are not yet touching the late, slowly proliferating population, which accounts for perhaps one-third of all relapses, particularly in ER-positive disease. This is where vaccines may be of particular benefit. In contrast, there was a curve for a particular therapy presented at San Antonio that showed no difference in the first five years, but the advantage accumulated in the second five years. The curve suggested the therapy showed no advantage against the rapidly progressive clones in the early relapsers, but that the advantage emerged in the late relapsers.
Hormone therapy is more balanced than chemotherapy in the impact on the second five years. In NSABP P-1 and B-14, the curves actually slightly diverge. The therapy is probably acting on the slower and stalled clones. This has not been adequately studied, and I think it’s worth some additional research."
link:
http://www.breastcancerupdate.com/bcu2003/2/ravdin.htm
Hopeful
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