Live 2005 SABC on the net now!!!!!!!!!!!!!

[RobinP]

Wow, I just watched the 2005 SABC live webcast with Dr. D. Slamon, discussing the trail results of BCIRG, and the speaker for the HERA discussing trail results. These webcasts were excellent presentations on the uses and risks of adjuvant herceptin.

I found it particularly interesting that in the HERA discussion, node negative her2+ er,pr+ subtypes only had a 9% risk of recurrence of bc in two year follow up. This risk was so low that the investigators will be watching this group in follow-up to determine if Herceptin is indicated in this subtype. On the other hand, node negative er, pr negative, her2+ subtype relapse risk was at an alarming 18%! The break down of risk for relaspe in 2 yr. f/u is as follows:

ER,PR Negative, her2+
Node Negative 18%
1-3 nodes 25%
greater 4 nodes 33%

ER,PR positive, her2+
Node Negative 10%
1-3 Nodes 12%
greater 4 nodes 33%


Dr. Slamon's presentation, was enlighting as well. He indicated that the cardiac risk for the AC-TH group was as high as 17% cardiac risk of over 10 percent presistent LONG LASTING damage to the heart. He said the heart loss was beyong 550 days; much longer lost than historically thought.He felt the AC-TH combination was only indicated if you test TOPOII positive where AC targets TOPOII and Herceptin targets her2+.Otherwise, AC combination with herceptin should be avoided due to CV risks.

This makes me wonder if the Finnish trail, who had no CV risk, has efficacy in the TOPOII subtype, in particular. Additionally, it looks like Herceptin AFTER adjuvant may be advantageous to herceptin commitant with AC as we know the HERA trail had much less CV risks of 0.5 percent severe CHF, 1.5% CHF and 7% one episode of decreased LVEF during infusion. Note, according to the HERA speaker, 95% of the adjuvant chemo in HERA was AC; however, this AC was not given with Herceptin as the BCIRG trial.