Perhaps 70% or more response rate to adjuvant Herceptin

[RobinP]

Perhaps more would be willing to do adjuvant Herceptin for very early stage disease and or late Herceptin if they knew that the response rate would be pushing near 70-75%.

According to the link below, 20% of the Her2+ node negative early stage breast cancers have p95 form of the receptor. As we know, p95 is truncated without the cleavated extracellular membrane for herceptin to fit into. Perhaps we can logically conclude that these 20% therefore would not respond to Herceptin. Conversely, we could conclude that if you have p185, then your response would be increased some 20% since you don't have p95.Accordingly, then you could conclude that your response rate to adjuvant Herceptin may be as high as 70%.

Okay, now here comes the big question, why aren't onclogist testing for these two forms of the receptors when these tests are available via of Western Blot and Tab250? I guess they are awaiting for in vivo study, human, to varify it all. But come on,the writing is on the wall, let's hurry HERA trial with those specimen analyses!!!!!!!!!!!!!!!!!

http://clincancerres.aacrjournals.o...nt/full/8/2/347
__________________
Fondly,
Robin

[dberg]

Robin,
I asked my onc about PTEN testing, which is different I know, but along the same vein, and he said that there are a lot of tests "out there" now that just aren't available to Joe Oncologist. Just wait till the insurance companies get wind of this!

Diane

[AlaskaAngel]

It is estimated that 60% of those diagnosed with early stage bc would never need anything but surgery. Maybe all of those who are HER2 positive are considered to be in the remaining 40%. Until now the percentage of HER2-positive have been estimated as being between 25% and 30% of all bc diagnosed. Considering that perhaps even a certain major cancer treatment center may not have been routinely testing all those diagnosed with bc for HER2 status to begin with, and add to that the recognized inaccuracy in a significant number of test results from local labs, we will probably see a larger percentage that test HER2-positive than have been counted in the past.

I'm told that if we make it to 2 years out, we are pretty safe, and that most who will recur will have recurred by then. But if the recommended cutoff for authorized use of Herceptin is 1 year out, and the safety margin is 2 years out then what about those poor souls who are stuck between 1 year out and 2 years out????

Another unanswered question is, what percentage of HER2-positives don't make it past 2 years (and thus also, what percentage do)?

Maybe by some odd chance, only those who are not HER2-positive recur after 2 years out?

But here is an interesting point made in an article written in 2001 that discussed the question of the length of time that a SERM should be used:

"There are almost as many breast cancer deaths in the second decade after diagnosis as in the first decade after diagnosis."

Does anyone here want to bet their life that HER2-positives don't usually recur after 2 years out? Or let their onc bet their life for them?

Re your comment on insurance, I am not sure exactly what you were thinking but is this a hint of the wind of future change with the massive potential increase in treatment costs.

Human nature/ the market place v equal treatment for all - which will win I know in the long term on the balance of probabilities which is the more likely.

RB


http://news.bbc.co.uk/1/hi/business/4711796.stm

ABSTRACT

Testing workers for inherited illnesses could lead to discrimination in the workplace and, if insurers were to get hold of the results, the potential for future health and life insurance cover to be denied, the groups warned.

[RobinP]

I found an interesting applicable link concerning late Herceptin featuring Dr. Love , Fox and Winer. I will post this link below. Basically, they discuss the idea of late Herceptin. Looks like they state that 33% relapse in the first few years. Supposedly they base their decision for no herceptin based on that fact. However, a 66% relapse rate remains which could be significant not only in the short 10 year survival stats but the longer 20 year stats.
http://www.meettheprofessors.com/mtp/2005/6/default.htm

try the below link for the direct case, otherwise use the above link and look at case 1

http://www.meettheprofessors.com/mtp/2005/6/case1.htm

According to Dr. Miller of Breastcancer.org, ER-negative have a higher rate of recurrences in the first FIVE YEARS after diagnosis, but the long-term prognosis is comparable with ER-positive tumors.

According to "Adjuvant Systmeic Therapy for Lymph Node negative Breast Cacner less than or Equal to 1cm," 66% of bc relapse is in the first 10 years and 33% in years 11-20.

Herceptin without chemo.

Given that

1. chemo can cause early menopause
2. from what I recall herceptin was not repored as impacting on fertility
3. "life factor issues" rank very much higher for you fertile sufferers, and the younger sufferers are reported as having the highest treatment dissatisfaction levels

might not herceptin without chemo be a valid option for younger sufferers to consider?

I have seen it suggested in one place the efficacy of herceptin is unknown in the absence of chemo ( a vague recollection in another that it was reduced).

Can anybody throw any light of the efficacity of herceptin without chemo.

If there any reason it should not work without chemo.

If it is chemo dependent what is it about the impact of chemo that allows herceptin to work.

If there have been no trails on herceptin alone why?

RB