Herceptin + Perjeta Slightly Better for High-Risk, HER2+ Disease

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Anonymous
Anonymous Member Posts: 1,376
edited June 2017 in HER2+ (Positive) Breast Cancer
Herceptin + Perjeta Slightly Better for High-Risk, HER2+ Disease
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  • Moderators
    Moderators Member Posts: 25,912
    edited June 2017

    Herceptin Plus Perjeta Slightly Better for High-Risk, HER2-Positive Disease Than Herceptin Alone
    June 16, 2017
    Adding Perjeta to Herceptin and chemotherapy after surgery to treat early-stage, HER2-positive breast cancer slightly improves survival; women diagnosed with high-risk, HER2-positive, early-stage disease got more benefits. Read more...

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited June 2017

    Hi:

    I don't understand this statement in your Feature:

    "The disease-free survival rate was higher than expected in both groups:

    • 94.1% of the women in the Perjeta treatment group were alive with no cancer recurrence
    • 93.2% of the women in the standard treatment group were alive with no cancer recurrence

    This slight difference was not statistically significant, which means that it could have been due to chance and not because of the difference in treatment."

    The statement that this result was not statistically significant does not appear to be accurate. For example, the NEJM paper clearly states:

    "In the analysis of the primary end point, the addition of pertuzumab was found to be associated with a significantly higher rate of invasive-disease– free survival than placebo (Fig. 1A)"

    The paper further states:

    "The 3-year rate of invasive-disease–free survival was 94.1% in the pertuzumab group and 93.2% in the placebo group, with a hazard ratio for an invasive-disease event of 0.81 (95% confidence interval [CI], 0.66 to 1.00; P = 0.045) in favor of pertuzumab."

    While the absolute improvement in the primary endpoint was modest (0.9%) in the group as a whole, isn't a P value of less than 0.05 statistically significant?

    In this regard, in this OncLive interview, in the first minute, the Dr. von Minckwitz, the first author of the NEJM paper, states that the trial "met its primary endpoint" showing a relative improvement of "19%" (consistent with the quote above that the hazard ratio was 0.81, meaning a 0.19 or 19% improvement), and that the benefit observed "was just significant at a P value of 0.045." In other words, it was a statistically significant difference.

    http://www.onclive.com/conference-coverage/asco-2017/dr-von-minckwitz-on-phase-iii-results-of-the-aphinity-trial-for-breast-cancer

    BarredOwl

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  • carmstr835
    carmstr835 Member Posts: 388
    edited June 2017

    Thank you for posting this result :)

    I sure hope my oncologist will let me have herceptin and perjeta. Tumor board meets today, I think regarding my future. He balked at TC but relented and seems to be not in favor of treating my Her-2. Anyone know if a port is required for these treatments, and is cold capping necessary? I am currently on TC and going for treatment 3 of 4 next week and so far have been using a pic-line that is removed after each infusion and the dignicap to keep my hair. Adding 17 more treatments might become cost prohibitive to keep my hair through these and I am not sure there's room for more pic lines on my only arm they can use bcause of the axilliary dissection on the other one.

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  • Moderators
    Moderators Member Posts: 25,912
    edited June 2017

    BarredOwl, thanks for your keen eye -- this was an error which as now been corrected!

    --The Mods

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  • zjrosenthal
    zjrosenthal Member Posts: 2,026
    edited June 2017

    Carmster, I had a port. It wasn't required but much easier than accessing my poor veins for each infusion. Also had an axillary disection so only could use one arm. Love, Jean

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  • carmstr835
    carmstr835 Member Posts: 388
    edited June 2017

    Good news. My oncologist will treat my Her2+ with herceptin and perjeta. Anyone have these 2 drugs, do you lose your hair? Do I need to continue the dignicaps through out the Her2 treatment after my TC is done to keep my hair?

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  • Magnolia83
    Magnolia83 Member Posts: 99
    edited June 2017

    I was so happy to read these results. I received Herceptin along with Perjeta adjuvantly 2 years ago...I brought up adding Perjeta to my onc and she made the case to the tumor board to give it to me even though it wasn't standard of care at the time and I would be the first patient at my hospital to undergo this regimen. 2 years later and I'm happy to be here!

    Carmstr, Herceptin and Perjeta is taken, at least initially, along with taxol/taxotere. Eventually the chemo ends but you keep on taking the Herceptin/Perjeta for a total of one year. The Herceptin/Perjeta doesn't cause hair loss, mine started to grow back while on it. The main issues I had with H&P were gastrointestinal issues...a delightful combo of diarrhea and constipation. And very occasional shortness of breath. Other than that they were a breeze...none of the icky chemo feeling!

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  • carmstr835
    carmstr835 Member Posts: 388
    edited June 2017

    Thanks, Jean. It is very good news I can keep my hair, I was rather stressed thinking about possibly losing it. I can deal with the gastrointestinal issues. I feel so relieved about the decision to give me the the treatment as well as the side effects. I feel much more positive about this whole cancer thing right now. I feel as if everything and everyone on my medical team is finally coming together after a very long decision making period.

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