Understanding the impact of HER2 on progosis/survival

sduch1

I also want to point out that even though disappointingly the combo of lapatinib and Herceptin achieved a higher rate of PCR in neoALTTO but did not produce a higher rate of DFS in the ALTTO trial, all 3 arms of the ALTTO trial still performed really well. 

From the article:

"Specifically, the proportion of patients who did not suffer a relapse was 86% in the trastuzumab arm versus 87% for the sequential drugs and 88% for the drugs given together.

The differences were not statistically significant.

Overall survival did not differ among the arms, with 95% alive in all three at 4 years."

sduch1

I like any large data sets that continue to uphold the current 85-90% DFS rate which seems to be a consistent outcome with Herceptin.

moni731

Interesting! I did neo-adjuvant AC-TCH.but only had only 1.5 tx's of AC (2nd dose of C was stopped immediately) and then no more Adriamycin either d/t to grade 4 febrile neutropenia with both infusions. On to TCH with the start of the 2nd Taxotere infusion went into anaphalaxis so no more of that. Also had problems with Herceptin, attempted rapid de-sensitization of the Herceptin and was able to tolerate a total of 12 weekly doses off and on over about 4 months. Onc finally said no more. Very disappointed with this, but understood the reason. Even with the very small amount of chemo, I still had a pCR at lumpectomy. My cardiac function at the beginning was 67%. Two years later it was 56%. Three years out it is now 42%, and I was dx'd with 'left ventricular dysfunction' and ' prolonged QT interval'. I will see the cardiologist 7/1 to see what to do. For all of this my risk of recurrence was pegged at 35%. Was it all worth it? I don't know. The impact on my life has been great. So far 3+ years out, I'm still NED as far as I know (no scans, etc.). My tumor markers bounce but CA 27/29 was 30 at last testing. I was not tested prior to tx, so no idea if it is accurate for me. I guess only time will tell.

sduch1

Np Kayb! I was preparing myself to also be depressed reading the article but then realized that although the trial didn't produce better results and a higher % of DFS (which I always pray they will---I would love the gap to close even more) it didn't perform worse and it still upholds the same stats as the other Herceptin trials. 

Corinne6

new to this thread...I had her2 positive breast cancer 6 years ago. I just read that it comes back in all but eight percent of people who have it....is that true? Found this on healthline.com

my4pumpkins

This piece from healthline is very misleading. The 7-8% who reach complete remission are patients with metastatic disease. See link:

http://blogs.nejm.org/now/index.php/her2-positive-...

To me, this is irresponsible of healthline to allow this misinformation, especially in light of the fact that this info was reviewed by a MD. 

SpecialK

I did not find it misleading because the word metastatic is used throughout the piece, it is specifically discussing metastatic Her2+ disease.

my4pumpkins

The healthline article Corinne6 is referring to is this one:

http://www.healthline.com/health-slideshow/her2-po...

I provided the link to the reference the author used. 

This original article does not indicate that it is referring to metastatic disease. Only when you look at the references is that made clear. The healthline article is titled HER 2 Positive Breast Cancer Survival Rates. 

SpecialK

pumpkins - sorry for the confusion, I looked at the only linked piece, which was the one you had in your post.  I looked at the other one, and yes, agree that it is misleading.  They have a set of stats in one slide that is contradicted by the slide that quotes the NEJM study, which erroneously leaves out the word metastatic.  Thanks for the heads up!

my4pumpkins

No problem Special K! I don't post here much, but I was just concerned someone newly diagnosed would come across that info and be very upset. Someone newly diagnosed could easily come across that info with a google search. I agree with kayb, I would like to find away to notify the author. AND the piece was reviewed by a MD! 

SpecialK

Here is the link to Healthline's contact page:

http://corp.healthline.com/about-us/#contact-us

And, their Facebook page, which would be a more public forum in which to criticize the slideshow content:

https://www.facebook.com/healthlinenetworks