~*Anthracyclines for Her2 BC*~

Lexis, lots of women who are HER2+ don't get an anthracycline based chemo and I think that's great. TCH is non-anthracycline, is highly affective and is lower risk for serious side effects than the anthracycline based AC-TH chemo.

The study you linked apparently showed that CEF (the E is an anthracycline) is better than CMF for TOPO2A over expressing cancers, The article doesn't say anything about Herceptin being involved and neither of those two chemos are the ones that seem to be most commonly given (at least in the US) for HER2+ cancer. TCH and AC-TH are the common chemo regimes for HER2+ and they were compared in the BCIRG 006 clinical trial.

TCH is a non-anthracycline chemo and AC-TH is anthracyline (Adriamycin).

The second interim analysis slide set on BCIRG 006 can be found at:
http://www.bcirg.org/Internet/Studies/BCIRG+006.htm 

Slides 30 to 37 cover the results for those in the study who had TOPO II amplified (about 1/3 of the participants).  At 4 years after chemo started, the results for the two therapies were similar even in the TOPO II amplified cases. The difference in recurrence was about 2%. 

About 2% of the patients in the AC-TH arm developed heart problems during the AC treatment that prevented them getting Herceptin and during the 4 years after chemo started, 2% in the AC-TH arm had Grade 3 or 4 CHF problems compared to 0.4% in the TCH arm. There was also a small Leukemia risk (0.4%) in the AC-TH arm.

Lower cardiac toxicity, avoiding heart problems preventing Herceptin treatment and avoiding the small risk of Leukemia from Adriamycin add up to good arguments for getting TCH therapy instead of AC-TH even if recurrence rates are slightly higher (the difference BTW was not statistically significant).

Thanks for posting this Lexi, always great to get latest and greatest info:)

I'm 54 years old and my oncologist was seriously concerned about the use of AC for my low-stage BC. I have no heart disease history - but still he was concerned enough to offer me a novel approach - Navelbine for four months every two weeks with Herceptin continuing for a year. (I finished the Navelbine last April and finished Herceptin last month, yay!)  I consulted with three other oncologists (two on the east coast and one on the west coast) and they all agreed with this unusual protocol. Sometimes I worry that I'm a "one-person study" but after all my own research, I've come to believe that very very soon Herceptin will be approved as the sole treatment for very early stage Her2+ cancers - of course, this doesn't exclude the use of Tamoxifen or Arimidex (I'm on the latter). My point in writing is that there is no "one-size-fits-all" chemo protocol and each of us must make the decisions that work best with our own medical histories.

Thank you Lexi for posting this information - and thank you everyone else for your responses. It's because of you very intelligent women that I feel more educated about BC - and with knowledge comes power! We all need to be as empowered as possible when dealing with this Beast!

Swimangel...

Just wanted to confirm that you are not a "one woman study". I was given Navelbine/Abraxane/Herceptin for stage IIb IDC. I am in a clinical study but docs felt that it was an aggressive treatment with less cardiac risk. In my 11 months of treatment I have only met one other woman getting my exact chemo regime. It's amazing how different each cancer is and what it responds to.

When I was dx'd in 2001 at age 45, AC chemo was standard protocol for HER+ women.  Herceptin was only given if you were Stage 4.  Back then there was absolutely NOTHING positive above being HER+.  You couldn't even find any information other than "high incidence of reoccurance!". So I probably would have taken anything the oncologist offered!

So I did my 4 rounds of AC....and 6 years later at age 51 ended up in the hospital with congestive heart failure.  I found out the left ventricle of my heart is damaged and the cardiologist says it is consistent with what he has seen with Adriamycin.  It never dawned on me the heart problems could show up years later but they can.  I wasn't overweight and didn't smoke., Nuclear stress tests and heart catherization showed I did not have any blockages.  My cholesterol has always been fantastic.  I have never had high blood pressure.  The only factor for my heart problems is the Adriamycin. 

The only thing I would recommend is that if you do Adriamycin, have a muga scan prior to the 1st chemo and regularly afterwards to watch for changes.  Also be aware of the symptoms of heart damage.  I had a time getting dx'd because I did not look sick and did not look like someone with heart problems.  My only symptom was shortness of breath.  When they admitted me into the hospital my ejection fraction had gotten down to 18%!  Now I am on heart meds and will be for the rest of my life.

Adriamycin really is the Red Devil!

Debbie

Estepp

Do you know that the DHA portion of the fish oil is all you really need to take?  From it the body can manufacture all of the EPA it needs.  From what I read, most products focus heavily on the EPA when it is the DHA faction that shows the greatest potential for prevention of cancer.

Also:  Great source for vitamins and supplements is Vitacost.com.  I think the NSI brand is the most consistent with pharmaceutical grade ingredients that are standardized.  Great prices on things like COQ10 and they have a $4.95 shipping fee no matter how much you buy.

Cathy