2 Year Hera Results????

orange1

Anyone know when the next major BC conference is?  I'm hoping the researchers will get around to publishing the 2 year results from the HERA trial

helena67

There was a St. Gallen conference in Switzerland in March of this year (don't remember the exact date). I browsed through the abstracts at that time and it was said that the results would be made public when ready, that is not before 2011.

:-(

-Helena.

orange1

Thanks for the info - now I can avoid obsesssing about it for a couple years.

bluedasher

I'm assuming that no news is no news - they must be monitoring the results and if the interim results were showing anything that would change treatment recomendations like an advantage for the extra year of Herceptin, they would have reported it. They reported interim results of the other  Herceptin trials and the 1 year of Herceptin for this trial with only a few years of follow-up because they showed that Herceptin was having a significant benefit.

It is frustrating to me that the Herceptin studies all released results in 2005 or 2006 when they had 2 to 4 years of follow-up and once they got their FDA approvals for the Herceptin based-therapies, they haven't put out anything additional. I'd like to know what recurrence and survival stats are looking like for 5 or more years after treatment. It doesn't look like any of them are going to release more results until they have 10 year results or something. 

:-{ 

sylwiamolik

Hello U.S Ladies,

Here You have an update of standard HERA trial (1 year of herceptin) after 4 years of follow up

http://www.senology.it/SGallen.pdf

mmm5

Can someone explain the difference between 15 and 16 it looks like the same slide  but different percentages on DFS?

orange1

Thanks for posting sylwiamolik - I hadn't seen this one before.

mmm5.  I can only speculate....  You're right that the titles and labeling on the graphs are identical, but the values are different.  I strongly suspect the that title of the 2nd slide (slide 16) should be OS (overall survival), not DFS.  Ususally OS is presented after DFS and it makes sense that there are fewer deaths than recurrences.

jap

Thanks for the update on the 4 year Hero trial.  I THINK it concludes that there continues to be risk of reccurance after the third year.  Would it be possible for someone to summarize the results in very general terms?  Does Herceptin continue to help those of us who took it for one year?  Does risk decline significantly after the third year?

Jo Anne

mmm5

Hi Ladies

From what my Onc has discussed with me and from my look at the Hera Joint analysis it looks to be that the curve has a leveling off effect after year 3. I am sure there are still some recurrance but When my Onc spoke of it he really expected the 5 year data to hold up at 10 years and he is in research. He actually put in an email for me.

sylwiamolik

Hello 

So in my opinion, as You see on the 6th slide, the DFS curve is getting more and more horizontal after about 30. month of follow up. The conclusion is that the biggest risk of recurrence is in the first 30 months after surgery and after that time (after these 30 months) the risk still exists but is much smaller and is still getting smaller over time. 

sylwiamolik

Besides, i read in some ASCO that HER2 status is only a factor of early recurrence (about 3-4 years after surgery) but has no influence on the outcome in longer term observation. After these 3-4 years the risk ratio in her2 positive and her2 negative is the same.

Sassa

Sylwiamolik,

You raise a point that I have often wondered about.  Because I am also ER/PR negative, I have also looked at the survival rates for triple negatives.  If, as you stated, the risk ratio is the same for Her2positive as for Her2negative after 3-4 years, the survival data for triple negatives becomes important in my case and  ER/PR positive data becomes important for ER/PR positive women.

For ER/PR-, HER2+ women, it implies that at 5 years our risk factor for recurrence is down close to zero and after 8 years, we can be considered "cured"  (this is based on readings I have done on trip negative disease).

 I am at 30 months post chemo, 33 months post surgery and guess I can start to breathe a bit easier as far as recurrence risk.

bluedasher

Thanks for the link slywiamolik. On slide 16, I agree with Orange that it should have been labeled OS - it looks like it fits with the OS graph on page 7.

It is interesting to compare the HERA results to the second interim analysis of BCIRG 006. Both are at 4 years of follow-up. HERA gave Herceptin after chemo and didn't require a specific chemo but 68% had Anthracycline based chemos and 26% Anthracycline plus Taxane. BCIRG 006 gave Herceptin starting it with a taxane chemo. It had arms for AC-T, AC-TH and TCH.

Both studies included node negative women, HERA had slightly more: 33% vs 29%. 

I notice that the DFS and OS numbers on BCIRG 006 are somewhat better than those on HERA. Perhaps this is because starting Herceptin with the taxane produces better results than starting it after chemo. NCCTG N9831 suggests that. Or perhaps the difference is because of the different chemo regimes - this is probably at least part of it since the non-Herceptin arm in BCIRG 006 also has better numbers.

In BCIRG 006, 4 year DFS is 82-83% with Herceptin and 77% without. In HERA, it is 79 and 72.

In BCIRG 006, 4 year OS is  91-92% and 86%. In HERA, it is 89 and 88 (this is probably high because of the number of women on HERA that had crossed over to Herceptin).

(They don't seem to have proofread the HERA slides very well. The red and grey line markers look reversed for the numbers on the bottom of the graphs vs the lines on the graphs.)

BCIRG 006 also shows the results for the node negative participants. The overall curves are flattening somewhat by 4 years, the node negative curves for DFS are getting very flat by 4 years. With Herceptin, there is only a 1% change from year 3 to year 4. 

For node negative on BCIRG 006, 4-year DFS is 93-94% with Herceptin 86% without.