you may not want to read this one if you got anthracyclines

[Lani]

I think the reason the study wasn't done earlier is the way clinical trials are devised. They have to give the "standard of care" treatment and then add something to it, so noone can complain they were somehow short-changed.

But when it turns out the "standard of care" which improved the survival characteristics when one looked at ALL breast cancers lumped together, only really benefitted 8% -24% of patients (depending if you go along with Dr. Slamon) was terribly skewed by the improved survival in a group(her2+s) which the other treatments (endocrine, etc) were less effective in, it makes you want to demand that they start dividing breast cancer into three groups (to start with):her2+s, triple negatives, and everyone else and try to find the best treatment for each group, develop a new standard of care for each, and then both add to the treatment, and subtract from it ie, see if a smaller dose of tykerb or a shorter course of herceptin would be just as effective. The latter type of trial is the hardest to do: legal and financial implications, of course.

It was not until her2 testing started being done, and then being done more exactly and consistently, that these trends began to appear.

Lesson: support biomarker research to help decipher how many types of bc there really are and detect the best treatment for each subtype.

At that point Becky's advocate handbook will be able to give better statistics to help the newly diagnosed make the best choices.