Article in NY Times today

couldn't get the link to work.  what were they saying?

followed the link.  Sigh of relief, it's not new information.  this info was around when I was first dx'd in 2007.  Yes, the cheaper test is not that accurate and the more expensive test is still not definitive either.  It goes along with no perfect mamm/us/mri test for bc. 

So, Are we having fun yet?

BTW- how did u get up to 9,000 posts since july seyla????

hugs to all

I'm impressed.  Have we spoken in chat or am I thinking of someone else?

flash

I've often wondered if the underlying science of Herceptin is sound? Her2 just happens to be one molecule which has been implicated in the process but there may be more. If it were the only protein involved, then one would expect that Her2 expression would correlate with Herceptin activity 100% of the time but it actually does so only about 20% of the time.

Many of these drugs cry out for validated clinical biomarkers to help set dosage and select people likely to respond. And optimal and reproducible Her2 testing continues to evade the diagnositcs of the disease. Numerous other genes, tumor, and patient factors contribute to the risk of the cancer coming back and the effectiveness of chemotherapy for breast cancer.

It could be vastly more beneficial to measure the net effect of all processes (systems) instead of just individual molecular targets. The cell is a system, an integrated, interacting network of genes, proteins, and other cellular constituents that produce functions. One needs to analyze the systems' response to drug treatments, not just one or a few targets (pathways/mechanisms).

What would be more beneficial is to test those pharmacodynamic endpoints with the ability to measure multiple parameters in cellular screens now in hand using flow cytometry. Using a systems biology approach where compounds are first screened in cell-based assays, with mechanistic understanding of the target coming only after validation of its impact on the biology.

Unlike a test for the presence of receptors to a specific antigen, which only "implies" dependence upon that antigen, a functional assay actually assesses the direct or indirect effect of the drug upon the whole cell, whether it is a tumor cell or an endothelial cell.

A "functional" assay doesn't just focus on Her2 or any one protein or mechanism. Whether it's Her2 alone (unlikely) or in combination with other proteins and other mechanical factors, the assay works by assessing the net effect of all those factors.

There are many pathways/mechanisms to the altered cellular (forest) function, hence all the different "trees" which correlate in different situations. Improvement can be made by measuring what happens at the end (the effects on the forest), rather than the status of the individual trees.

 www.ecancermedicinesciencetv.com

If you can get through all three of his modules it explains alot about pathology, herceptin, her2 and diagnosing breast cancers with a better understanding of what types of treatments needed. I enjoyed the information and watched all of Professor Vailes modules.  I like that they discuss the need for better pathology done on bc tumours.  Hope you all find this as interesting as I did.

Professor Giuseppe Viale - European Institute of Oncology

How to test for HER2, the lessons and pitfalls - Molecular Pathology Education Module 1

Module 1: Optimal HER2 Testing
Professor Viale, from the European Institute of Oncology, addresses the technicalities of HER2 testing and its clinical implications.

Module 1 of 4

Views: 467   Added: 17/02/2010