Tamoxifen Resistance in Her2+ - what to do?

[Lani]

her2 breast cancer recurs earlier, spreads more extensively and has a shorter survival time (in the days before herceptin) and is more often resistant to various chemos and hormonal therapies than breast cancer as a whole.

At a lecture I attended yesterday by Joel Gray, who got this year's Brinker award at SABCS he highlighted what he called luminal/amplified (50% of which are her2+ER+) and basal which included ER-s as the two worst subtypes which skew all the rest of the breast cancer statistics when you examine breast cancer as a whole.

Another thing to think about is whether these subtypes appear more often at earlier ages, skewing the statistics similarly. Just as blacks have a poorer prognosis--partly because of poorer access to early detection and care and partly because they are more likely to have triple negative breast cancer.

These old statistics based on all breast cancer thrown together need to be thrown out with the bathwater to allow in new meaningful statistics based on subtypes of breast cancer so that we may learn the best way to treat each individually instead of giving anthracyclines to 92% of breast cancer patients who, according to Dr. Slamon's talk at SABCS, will gain no benefit from them and only expose themselves to possible health probles from them in order to gain some benefit in the 8% of patients who will benefit. And only by separating out those 8% have they found that their benefit with anthracyclines is no greater than if they were given TCH alone. They 92% and 8% figures and the equivalency of treatment of those 8% were all from Dr. Slamon's talk at SABCS and couldn't have been generated without learning from biomarkers how to differentiate subtypes of breast cancer.