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06-05-2011, 03:11 AM
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#1
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Senior Member
Join Date: Mar 2006
Posts: 4,778
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at ASCO meeting heard Dr. Robert Carlson of Stanford
(usually one of the most conservative voices on many committees setting national standards) say that the next thing he sees is trials to determine which her2+ bc patients can be treated without chemo-- not just those best treated with herceptin+lapatinib or herceptin+pertuzumab, but also herceptin alone.
I always imagined he would be one of the last people I would hear this from having heard him speak at multiple meetings.
Here's to hoping for some day in the not too distant future when her2+ patients won't have to undergo nontargeted treatment
His comments were made during a panel discussion presented by ( andvideo'd) Dr. Neil Love's organization (had the word "controversies" in the title) so it should be available online sometime soon
Lots of discussion of adjuvant treatment and treatment of Stage IV her2+ breast cancer during the panel.
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06-05-2011, 08:15 PM
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#2
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Senior Member
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
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Re: at ASCO meeting heard Dr. Robert Carlson of Stanford
I am so happy to hear that. If I would have had a choice of Herceptin alone or Herceptin with another targeted therapy I would have chosen that.
__________________
Diagnosed 2007
Stage IIb Invasive Ductal Carcinoma, Pagets, 3 of 15 positive nodes
Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
Former Chemo Ninja "Takizi Zukuchiri"
Additional treatments:
GP2 vaccine, San Antonio Med Ctr
Prescriptive Exercise for Cancer Patients
ENERGY Study, UCSD La Jolla
Reconstruction: TRAM flap, partial loss, Revision
The content of my posts are meant for informational purposes only. The medical information is intended for general information only and should not be used in any way to diagnose, treat, cure, or prevent disease
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06-06-2011, 06:22 AM
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#3
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Senior Member
Join Date: Jul 2008
Posts: 186
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Re: at ASCO meeting heard Dr. Robert Carlson of Stanford
"Here's to hoping for some day in the not too distant future when her2+ patients won't have to undergo nontargeted treatment"
Failure to account for "ALL" non-targeted treatment was reason for FDA refusal to even look at data that showed what T-DM1 could do for 3rd-line HER2+ MBC patients. Need to see those regulations upgraded to reflect a more individualistic health care approach and hopefully FDA Congressional Oversight Committee is busy getting the ball rolling.
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06-06-2011, 10:56 AM
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#4
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Senior Member
Join Date: Oct 2005
Posts: 3,519
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Re: at ASCO meeting heard Dr. Robert Carlson of Stanford
I love Dr. Neil Love's panels... always very thought provoking and informative. He's one of the sharpest knives in the drawer.
I tend to doubt that the FDA will ever move more towards approving treatments with an eye on individualistic approaches ~ even though that's where the research is taking us... because the govt's ever devolving version of a 'health system' has been devised, engineered and manufactured to treat one size fits all (except those who it doesn't, oops, oh well) because it's cheapest and most uniform.
But, one can hope.
__________________
Brenda
NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)
Nov'03~ dX stage 2B
Dec'03~ Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~ Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~ micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~ micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg
Apr'07~ MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~ Started Tykerb/Xeloda, no WBR for now
June'07~ MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~ MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~ PET/CT & MRI show NED
Apr'08~ scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~ MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~ dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~ Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~ new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~ new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~ 25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.
"I would rather be anecdotally alive than statistically dead."
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06-06-2011, 05:29 PM
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#5
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Senior Member
Join Date: Sep 2005
Location: Central Coast, CA
Posts: 3,207
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Re: at ASCO meeting heard Dr. Robert Carlson of Stanford
Schoonder - I picked up on that two. Didn't know whether to laugh or cry at todays WSJ front page article from ASCO in which the FDA's Janet Woodcock said they were doing just that...
Sadly, they seem to be heading the opposite direction based on the TDM1 decision.
__________________
Chris in Scotts Valley
June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?"
9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++
10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!
04/05 - 4/07 Herception every 3 wks, Continue NED
04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial
06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin
01/08 Progression in liver
02/08 Begin (TDM1) trial
08/08 NED! It's Working! Continue on TDM1
02/09 Continue NED
02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED
12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver
07/11 - 11/11 Herceptin/Xeloda -not working:(
12/11 Begin MM302 Phase I trial - bust:(
03/12 3rd times the charm? AKT trial
5/12 Scan shows reduction! 7/12 More reduction!!!!
8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!)
9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3
11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc
11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go.
2/13 Gemzar/Carbo/Herceptin - no go.
3/13 TACE procedure
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06-06-2011, 09:44 PM
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#6
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Senior Member
Join Date: Feb 2008
Location: South East Wisconsin
Posts: 3,431
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Re: at ASCO meeting heard Dr. Robert Carlson of Stanford
If chemo/targeted agent sensitivity testing were part of the initial surgery, I can't help but think better use of resources could dovetail with better outcomes.
And I really hope immune system based approaches targeting more generic markers (PSMA etc) keep gaining ground. Need to gain it faster...
But here's another her2 based approach seemingly moving forward, NeuVax: http://www.bizjournals.com/boston/ne...r-vaccine.html |
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06-06-2011, 10:01 PM
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#7
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Senior Member
Join Date: May 2009
Posts: 510
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Re: at ASCO meeting heard Dr. Robert Carlson of Stanford
This is great, Rich! Thanks for posting about this vaccine. I'm
almost done with my vaccine trial and so far, so good.
__________________
ER+ (30%)/PR-/HER-2+, stage 3
Diagnosed on 02/18/09 at 38 with a huge 12x10 cm tumor, after a 6 month delay. Told I was too young and had no risk factors. Found swollen node during breastfeeding.
March-August 09: neo-adjuvant chemo, part of a trial at Stanford (4 DD A/C, 4 Taxotere with daily Tykerb), loading dose of Herceptin
08/12/09 - bye bye boobies (bilateral mastectomy)
08/24/09 - path report shows 100 % success in breast tissue (no cancer there, yay!), 98 % success in lymphatic invasion, and even though 11/13 nodes were still positive, > 95 % of the tumor in them was killed. Hoping for the best!
September-October 09: rads with daily Xeloda
02/25/10 - Cholecystectomy
05/27/10 - Bone scan clear
06/14/10 - CT scan clear, ovarian cyst found
07/27/10 - Done with Herceptin!
02/15/11 - MVA-BN HER-2 vaccine trial
03/15/11 - First CA 15-3: 12.7 and normal, yay!
10/01/11 - Bone scan and CT scan clear, fatty liver found
now on Tamoxifen and Aspirin
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06-08-2011, 12:59 PM
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#8
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Senior Member
Join Date: Feb 2008
Location: South East Wisconsin
Posts: 3,431
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Re: at ASCO meeting heard Dr. Robert Carlson of Stanford
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