How much does Herceptin improve HER2/neu + prognosis?

If it helps...my oncologist told me my chance of recurrence is 7-10%. Without Herceptin it would be 35%. There is so much conflicting info and I can read myself into circles. I have decided to go with what my medical oncologist has said and even though I had aggressive cancer prognosis is good and better because of Herceptin.

Hope it helps...Kris 

Hi there - my treatment plan was modified after results from the post-mastectomy pathology report to include chemo, including Herceptin. According to my oncologist, TCH therapy (four full cycles, with H for one year) will cut my approx. 23% rate of recurrence by 75%. We're going to bring that down even further with 5 years of Tamoxifan. My understanding is that H is also the best option for women with E- and/or P- since Tamoxifan isn't as effective by itself in that situation. I had my first round last Thursday and it was a little rough, but manageable. Of course, there are many more to come, but like you I want to get those odds DOWN! Good luck and take care...Kristen  

Herceptin reduces the risk of recurrence by 50%. Your chance of recurrence is entirely dependent on your staging and pathology ... but whatever the number is, cut it in half with Herceptin. It's that simple.

Most of what you read on the Internet about Her2 recurrence is old data and does not factor in the most recent long-term studies.

I was told by 2 different oncologists that my chance of recurrence was close to 40% without chemotherapy and herceptin, but that was cut in half (less than 20%) with chemo and one year of herceptin treatments.  If herceptin is approved for more than one year, this could lower the chances even further. 

Hi Sassa,

Do you have any specific information regarding which study(ies) showed that more than one year of herceptin is no more effective than one year?  The only large study in the adjuvant setting that I am aware of that compared one year vs more than one year is the HERA study.  I have not seen results of the 2 year arm of the HERA study yet.  Any additional information you can provide is appreciated.

Thanks,

Jackie 

I didn't say that herceptin given for more than one year is not effective.  The longer dosing of herceptin, however, has the same effectiveness as one year (in early stage disease).

What does change is the rate of cardio-toxicity as herceptin  is given longer than one year.  The longer herceptin is given, the higher the possibility of cardiac side effects.

As I have mentioned before, the new thinking is that a shorter time of treatment (3 months vs one year) may be as effective as one year of treatment.  More studies need to be done to support the one study that shows this outcome or may eventually be  supported by historical data accumulated in countries with socialized medicine that only permits the shorter courses of treatment.

Sorry, Jackie.  I can't give you a study number.  The data is not available to the public.

Since it's been four years since my diagnosis and treatment for stage llb, HER2+++ BC, I haven't kept up with the latest research on the length of Herceptin treatment. In my case, I was not able to do an entire 12 months, due to decreased heart function. We stopped after 8 months. I spoke with Dr. Dennis Slamon at UCLA, and he told me that the 12 month regimen was an arbitrary number that they initially chose when setting up the treatment guidelines. He felt that 8 months was entirely adequate, and pointed out that there had been a Finnish study that seemed to indicate 9 weeks - 3 months, might suffice. 

can we bump this again and does anyone have a formula, I have been told so many different things on stats.

First when I got the oncotype they stated 15% risk of recurranc in 10 years with an AI and CMF. Both my top Onc's state that this is old data and no one uses CMF anymore and it doesnt work on HER2 anyway. Then they said 12% risk if I use an AI and TCH.  I am also in BISPHOS study and they said that would reduce risk further.

Now last week I met with the top ONC at U.of Arizona and he runs a part of the national study for BISPHOS and has worked at MD Anderson etc etc.

He now says in retrospective studies with Herceptin node negative women, it looks like my risk of recurrence is more like 5% and that HER2 is now best  prognosis. I didn't get a chance to ask him how he comes up with that number because I was too  busy going through all of my other hypochodriacal questions, but just wondered what my other HER2 sisters have heard on stats.

mmm5.  Your onc got his stats from the HERA subgroup analysis.  It was a study that looked at the data from the HERA trial and broke results for various subgroups, node + or -, er + or -, also various combinations of bc attributes. 

Liz where did you get your stats, don't get me wrong I love them, but I thought the 50% included Herceptin with Chemo together. I hope I am wrong.

Its confusing, I am on Arimidex, final Herceptin, and in the Bisphos trial, if I added all these reduced risks I would have no risk which I know is not true but can't figure how to add it all together. Maybe it isn't something for me to dwell on, its really its either going to recur or not.

Wish I could make it that simple!!

My oncologist told me chances of recurrence in my case is 7-10% with Herceptin and 35% without Herceptin. Just like everything in this process...there is a lot of conflicting info.

Swimangel-

I know what you mean about getting breast cancer from the get go.  I come from a family of longevity. I have an aunt that's 104 and others who are well into their 90's etc. There's no family history of breast cancer (I'm the youngest of 6 girls) and look what happened to me at the age of 38 while my youngest child was only 8 months old. I have done everything right, stayed in shape, ate right, exercised etc.  Usually I'm OK but at times I get angry on why bad things happen to good people and why life sometimes isn't fair. After that I try to remind myself to do a reality check and tell myself that I shouldn't waste my energy on negative thoughts and to move on and focus on my family.  All we can do is stay vigilant and live our life to the fullest.  

Wishing you the very best,

Liz 

My oncologist told me that the statistics on Her2 positive breast cancer look scarier than they should because a lot of women end up not following up with the same doctor, etc.  and hence the statistics don't always show the real picture.  I went to the Mayo Clinic and that was a question I posed and I was told that after treatment, they usually never see the women again!