Both HERA and the Finnish trial had low cardiotoxicity. The anthracycline used in the Finnish trial was epirubicin (the E of FEC), sold under the trademarked name Ellence, and many of the women on HERA would have had FEC, since epirubicin is more common that adriamycin in most of Europe. M.D. Anderson made news at ASCO 2004 by giving women FEC+herceptin AT THE SAME TIME to patients and getting a really good response rate and there weren't heart problems, whereas AC at the same time as herceptin caused heart failure in 25% of patients with secondaries in a separate trial, which is why it isn't done. Perhaps this is something that the oncologists should consider when designing future trials. I don't think that FEC and AC have ever been run head-to-head.
Topo IIa amplification (or deletion!) seems predict FEC sensitivity, whereas HER2 does not (as I know all too well :-(
http://www.ncbi.nlm.nih.gov/entrez/q...514&query_hl=3
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