Could This Breast Cancer Vaccine Be a Game Changer?

This article is confusing me. It states the vaccine is for Her2 negative, but then goes on to say it could be used in conjunction with Herceptin for Her2 positive women. I'm obviously reading this wrong. Gonna check into it a little more.

cp- As always, thanks for posting. I tried to get into this trial early on but was too far out from treatment. The initial results seem really promising!

colt - FISH and IHC are two different tests, you can't convert one into the other - here is some info on the difference (2nd link). If your FISH is equivocal they usually move on to do the IHC because the method is different.  If your wife tested negative, or unequivocal, on FISH there would be no reason to do the IHC.  I looked at the trial enrollment criteria for Neuvax and it states a FISH of less than 2.2.  I linked the page for you:

http://www.neuvax.com/about-the-trial/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706184/

leggo - I am in the vaccine trial linked below.  It is for Her2+, but they just started enrolling lower expressing Her2 (essentially Her2- patients) into one of the arms - the AE37 arm, which are sorted by histological tissue types (like for transplants).  They have found that this particular vaccine, which was developed for recurrence prevention for Her2+, also helps low-expressing Her2-.  I think there is a lot that is not well understood about treatment for Her2, partly because of the non-homogeneity of tumors, and Her2 response to treatment.

http://clinicaltrials.gov/show/NCT00524277

"NeuVax targets approximately 50-60% of HER2-positive patients (IHC 1+/2+ or FISH


This part confuses me.



The claim here says the drug is for HER2 POSITIVE patients with FISH < 2.2.



But many patients with FISH < 2.2 are actually HER2 NEGATIVE, as anything < FISH 1.8 is HER2 NEGATIVE.



Are they just unclearly saying they want those with FISH 1.8 to FISH 2.19999999999999?



Does a person with FISH 1.4 qualify? On 1 hand it's < FISH 2.2, but on the other hand, it's NOT HER2 positive.



What am I missing?

SpecialK, thanks for your explanation.


Edited to remove my griping about all this crap.

I was looking at different sites and articles trying to find info on FISH ratios of 1.4 and came across an explanation that makes sense to me.



SpecialK, you may likely be already aware of this, but I will share in case it helps anyone else understand FISH ratios better.



The HER2 gene/ chromosome 17 ratio should be 1.0 to 1 in a normal NON-DIVIDING cell.



With FISH testing, they supposedly look at 60 cells on a slide and come up with an average number of HER2 genes/ chromosome 17.



In normal cell division, the ratio can go up to 2.0 to 1 in certain stages.



This could account for why a ratio could be 1.4 to 1------and still be deemed 'non amplified'.... because the 1.4 is within the range of the normal cell division process.



This point had been escaping me and I was struggling to understand how 1.4 could still be 'normal', as I thought it HAD to be 1.0 to 1.



Darned normal cell division at the point of tissue preparation!



Kind of like catching people with their eyes closed during a group photo. They were just blinking right at the time you took the shot----and were not necessarily sleeping, dead or unconscious.



Scoring problems can occur when the HER2 gene/ chromosome 17 ratios are in the 1.8 to 2.2 range, as the ratio couldn't be above 2.0 and still be explained away as 'normal cell division'. (I guess 1.8 is where it starts to get 'too close' to just attribute to normal cell division----but I'm just guessing).



Anyway, the neuvax vaccine MAY benefit some people with a FISH ratio of 1.4----and I guess an arm of that trial is trying to shed further light on this... BUT I think I'm through with thinking there HAS TO BE something amiss because my wife's FISH ratio wasn't exactly 1.0 to 1. A study I read about had a sample of patients with non-amplification whose FISH ratios ranged from 1.05 (to one) up to something like 1.7 (to one). In other words, NOBODY had precisely 1.0 to 1... because EVERYBODY had normal cell division going on at the point of tissue preparation.



One of the links that SpecialK shared surprised me with how relatively FEW initial tests for HER2 are done by FISH. Those links were very informative, SpecialK!