TOPO II TEST

tomatojuice

TOPO II TEST

tomatojuice

Has anyone had this test? And, does anyone know how long it would take to get it?

Cathy-CA

I did not have it and here's why.  I discussed it with my onc and her concern was that only one study shows a link between topo 2 and adriamycin's effectivenss.  That study (according to her) was a retrospective study meaning they went back and looked at existing data rather than designing a study to specifically test for this.  There can be unaccounted for variables in a retrospective study that end up leading to conclusions that can't be replicated.  She felt my learning whether or not I was topo 2 shouldn't be the sole basis for making a treatment decision.  That's not to say that new research may not come along that makes it as important to know as Her2 or hormone receptor status, but for now, she felt it wasn't critical information.  Her explanation made sense to me and since I had already decided I didn't want adriamycin, I didn't bother with the test. 

I can't believe that postponing the start of chemo by a week or two to wait for results will be a problem for your oncologist.  Since attitude is such an important piece of the equation, if you feel more confident in your decision by testing for this first, you should do it.

TenderIsOurMight

Recently, in their 2007 publication: " American Society of Clinical Oncology 2007 Update of

Recommendations for the Use of Tumor Markers in Breast Cancer"

(JOURNAL OF CLINICAL ONCOLOGY VO L U M E 2 5 N O V E M B E R 2 0 2 0 0 7)



testing for topoisomerase II was discouraged: " the uncertainty regarding the biologic relationship between Topo II protein expression, copy number, proliferation, and benefit from anthracylines makes assessment of Topo II unreliable at this time. " (page 5293)



Additionally you may find the following pertinent for your consideration:



"Sensitivity to Chemotherapy 2007



Level II evidence (prospective therapeutic trials in which marker utility is a secondary study

objective) suggests that overexpression of HER2 (3􏰀 by protein or

􏰁 2.0 FISH ratio by gene amplification) identifies patients who have

greater benefit from anthracycline-based adjuvant therapy. If a clini-

cian is considering chemotherapy for a patient with HER2-positive

breast cancer, it is recommended that an anthracycline be strongly

considered, assuming there are no contraindications to anthracycline

therapy. In the context of trastuzumab therapy, there is Level I evi-

dence (single, high-powered, prospective, randomized controlled tri-

als specifically designed to test the marker or a meta-analyses of well-

designed studies) that a nonanthracycline regimen may produce

similar outcomes.



At present, the Update Committee does not recom-

mend that HER2 be used to guide use of taxane chemotherapy in the

adjuvant setting.



The previous discussion notwithstanding, most correlative

studies have suggested that HER2 amplification and/or overex-

pression identifies those patients in randomized trials who benefit

from anthracycline-based chemotherapy compared with CMF,

while in HER2-negative patients there appears to be no difference

between the two regimens.115,130,131 Thus, given the weight of the

evidence for HER2, it seems prudent to recommend anthracycline-

based adjuvant chemotherapy for a patient with HER2-positive

breast cancer, assuming adjuvant chemotherapy is indicated, the

patient has no contraindication to an anthracycline, and trastu-

zumab administration is not planned. " (page 5293)



The full text of the above (and more) may be read at:



http://jco.ascopubs.org/cgi/reprint/25/33/5287?ijkey=a75a4d93695e979f5051f481ad4240fb61bc7713

TenderIsOurMight

Tomato juice,



Did you see the TCH vs ACTH thread under HER disease? It's a well developed thread, lots of posts to it, and you may find some peace in what the ladies said as they apply to your concerns.



Just wish to make sure you're aware it is there, before tomorrow when you get your chemo.



Sorry for your struggles with this decision.

Tender

Erica2

Cathy and TomatoJuice, I didn't get the TOPO test either. In my case my oncol was pushing me hard to start therapy. I was 7 or 8 weeks beyond DX and he thought that was getting very near the limit of what he was comfortable with. In my case from all that I had read I really didn't think the test would have changed my decision anyway so there was no need. Glad you are near the end. Also good for you for not postponning the fun things in life in the midst of all this. Distractions are good for the soul.



Thanks for being here...

katymom

Tomatojuice:

I did have the topIIA test......I have read good reports on it...  I am her2 positive, ER+.  My topIIA test was non amplified which means that the anthracyclines would not have been as effective for me.  Therefore, I chose to go with TCH.....based on the BCIRG0006 clinical trial.  It didn't take long to get the blood test back from the lab in California.....Good luck with your decision.  I am personally glad that I did not have to combine an anthracycline with Herceptin.

janet11

My onc requested the topoII test for me too, and based on its results, I had TCH.  That was over a year ago. She says that now she wouldn't request the test, but she would STILL have recommended TCH for me.

Janet 

AlaskaAngel

Hi Janet!

I was treated 6 years ago before there was any real info about TOPO II,  but I'd love to know my TOPO II just out of pure curiousity since I am still NED and I never had either a taxane or trastuzumab. But sadly back then the treatment was not AC it was CAF, so I did get the 5-FU (reported to cause chemobrain damage that gets worse as time goes by). Likely some of the drugs used currently will have long-term adverse effects as well, and we just don't know yet what they are. We just have to hope for the best.

A.A.