MAMM article HER2-Promising Times Ahead

ejlj

http://www.mamm.com/highlights.php?&qbackid=4978e64258089938_88072&qbacktitl=Current%20Issue&seq=1 I'm not sure if this was already mentioned in this forum but thought you all would like to see it.  I just read it today and thought it had some good and promising information in it.  One of the docs was actually quoted as saying "HER2 positive means, on average, a better outcome than the average breast cancer.  The drugs have flipped the results."-  They're finally saying it.  Part 2 will be in the next article on HER2 vaccines.  Tina

Sassa

Based on my reading of various studies and just paying attention to the diagnoses of women on this board who have progressed and had a recurrence, my opinion is that eventually the hormone positive, HER2 negative BC  will be the least desirable form of BC and the one with the worst prognosis and outcomes.

snowyday

Her2 is nasty really nasty but they are making good strides in helping her2 bc patients, I'm hopeful, but hate herceptin. 

lexislove

Ohhhh...that made my day!

Thanks for posting!

ejlj

snowyday do you hate the herceptin because of the side effects or because it failed you?  Just curious.  How are you doing and what treatments are you receiving?  I'm hoping whatever it is, it's working for you!  Tina

Maryiz

Gees, Sassa, that doesn't bode well for me if that is true.  I am 100 percent ER positive.  I hope they don't forget us since we always have estrogen in our bodies.  Maryiz

mom_of_2

Hi Tina...Thank you for the link! I love promising research.

Kris 

mmm5

Sassa

Was wondering if you could elaborate a bit more, from my research and discussions with several top Onc's they tell me that triple negative seems to be have a poorer prognosis than ER+,

I was with the head Onc yesterday at U of A and he has worked at MD Anderson etc. and he states that the prognosis for early HER2 gets better and better. When I was first dxed they said most likely a 10-15% chance of lifetime reocurrannce, now with retrospective study they are giving me only a 5% percent chance of reoccurance. I never know who to believe, I have several friends that were stage 3C Her2 positive that have no recurr. after 5 years yet I believe there are some that Herceptin has not worked.

What is everyone else hearing?

lexislove

mmm5,

Both my oncs have stated that being Her2+ is the better, if you can use the word better with cancer, of breast cancers.

They stated before Herceptin Her2 disease was difficult and stubborn but NOW...it has the best prognosis. At my last Herceptin infusion in Nov 2008....my nurse said how lucky I was to be Her2+! Huh? What? When I was first diagnosed I was a mess reading about prognosis ect. Now I see what she means.

And yes...unfortunatly there are some woman where Herceptin has failed. But I think that it is a smaller majority.I think more comes into play with those woman like  a large number of lymph nodes involved.

jill323

Hello all !  Wanted to weigh in on this because I had already read the article.  A couple of clarifications:

1) The prognosis for Her2 positive cancers has indeed improved dramatically with the development of herceptin.   However, there is still some inconsistency as to when to prescribe and when not to based on on tumor size.   The MD Anderson study referenced both above and in the article recommends that any Her2 positive tumor be "considered" for systemic treatment, specifically anti-her2 agents (i.e. herceptin) regardless of tumor size (this study only examined tumor sizes less than 1 cm).  This is a change to current thinking in which the standard protocol was to consider systemic treatment for only those tumors over 0.5 cm.   This study basically made Her2 a defining consideration as opposed to size.   The study found that over expression of Her2 to correlate to a 3-4 higher incidence of recurrence vs. her2 negative tumors, regardless of tumor size.   However, as we know, those odds change dramatically when herceptin is introduced.  

2) Given the multiple tumor types out there and the treatments available, it is still generally a "positive" to be highly ER/PR positive because this means that the hormone therapies will "work".  They have been proven to be effective over the years and the prognosis is better when using those therapies for those women.   The effect is additive to any effect from treating her2,  and hence, the prognosis even better.  I hope that makes sense.

 3) By and large, given advancements in Her2 treatment, triple negative is largely considered now the most stubborn to treat.   The reason for this is that there are not readily available treatments that are proven to work beyond standard chemotherapy for this type of disease (i.e. no hormone therapy, no herceptin).  

 4) There are still other considerations playing in here that have to be taken into account when thinking about a treatment protocol.  Age, menopausal status, ER/PR status, tumor size, node status still play an important part.  In my case, for example, while I had a little itty bitty tumor, I was on the down side of all the prognostic indicators (43 years old, weak ER, PR neg. pre-menopausal, her2+, etc).  Because of the combined effect of these factors, my doc was a little more aggressive with me.   Goes to show there is still some art in the science. 

In general, my take is that tumors that have a Her2 overexpression are still considered the most "aggressive".  However, the development of anti her2 agents such as herceptin has made a world of difference in terms of our prognosis.   While I don't exactly like having to go through a year of this treatment, for me, the benefits far outweigh the inconvenience (especially as they are monitoring my heart function closely).  

I hope this helps and good luck to all you ladies out there !

Jill

lexislove

Thanks Jill for your input!