Talk Cancer

Question:

Tonight on the local and national news they reported about how Herceptin was helping the survival rate of those with this  certain type cancer. Does anyone know why doctors have not given the drug to others who are Hert and ER+?   I was never offered the drug or the opportunity to even be in the clinical trials.  Are there certain criteria they look for in bc patients before they give them this drug?   I am already on Arimidex and wonder if they do not allow one to take both drugs.   My doctors seem to prefer not to discuss any details of the bc with me. I only found out I was Hert and ER+ at my last visit with the radiation doctor.  I was diagnosed in 8/03  have already undergone a lumpectomy, Chemo, Radiation and now on the Arimidex.  Should I be on the Herceptin from what you all know about this drug?   I am sorry to bother you with my concerns but I have no one else to give me answers.   Will you please share any information you can with me so that I can ask my Oncologist the right questions when I see him in June?  Thank you so much for any help you can give me. Bea

Response:

- Hide quoted text — Show quoted text – Tonight on the local and national news they reported about how Herceptin was helping the survival rate of those with this  certain type cancer. Does anyone know why doctors have not given the drug to others who are Hert and ER+?   I was never offered the drug or the opportunity to even be in the clinical trials.  Are there certain criteria they look for in bc patients before they give them this drug?   I am already on Arimidex and wonder if they do not allow one to take both drugs.   My doctors seem to prefer not to discuss any details of the bc with me. I only found out I was Hert and ER+ at my last visit with the radiation doctor.  I was diagnosed in 8/03  have already undergone a lumpectomy, Chemo, Radiation and now on the Arimidex.  Should I be on the Herceptin from what you all know about this drug?   I am sorry to bother you with my concerns but I have no one else to give me answers.   Will you please share any information you can with me so that I can ask my Oncologist the right questions when I see him in June?  Thank you so much for any help you can give me. Bea

Herceptin is a "dangerous" drug, in that is has a significant risk of severe side effects (in particular congestive heart failure) and at the moment outside of some clinical trials, is only given to stage IV patients, who have relatively little to lose.  I have not heard of any trials that are recruiting at the moment. There is no particular problem with combining it with Arimidex. It is also quite expensive, and to justify its use you have to be stage IV, HER2+, and likely to benefit from it in terms of prognosis, e.g. not already at death’s door or suffering form other major complications. Even then a significant proportion of patients who receive it do not see any benefit, but for those who respond it can be dramatic. Tim Jackson

Response:

Tonight on the local and national news they reported about how Herceptin was helping the survival rate of those with this  certain type cancer.

Talk to your oncologist.  If you are suitable both as to the type of cancer and the strength of your heart you should push for this because the trial results are so spectacular My wife had a year of Herceptin as adjuvant chemo under a Mayo Clinic trial. They monitored her heart throughout and at one point the ejection rate dropped so much that they stopped the drug for four weeks, but her heart bounced right back and she completed the course.  Needless to say we’re thrilled with the trial results!

Response:

- Hide quoted text — Show quoted text – Tonight on the local and national news they reported about how Herceptin was helping the survival rate of those with this  certain type cancer. Does anyone know why doctors have not given the drug to others who are Hert and ER+?   … Bea Herceptin is a "dangerous" drug, in that is has a significant risk of severe side effects (in particular congestive heart failure) and at the moment outside of some clinical trials, is only given to stage IV patients, who have relatively little to lose.  I have not heard of any trials that are recruiting at the moment. … Tim Jackson

It’s big news here (US) that they’ve stopped a trial early, because of the dramatic increase in disease-free survival in the chemo+herceptin arm, in order to add herceptin for the control group. A few points I’ve gathered only from the news reports (dangerous source!): – Of course, this applies only to the Her+ group, which is only about 30% of BC cases – The trial was testing a combination of standard chemo plus Herceptin (one doctor interviewed described it as a "one-two punch") against standard chemo alone – The side effect rates (possibly gleaned from other longer-term studies than this one; not clear) was much lower than the DFS improvement, i.e., cost/benefit was strongly positive. – Overall survival data isn’t yet available, and presumably won’t be coming from this study given the treatment change being made. Speaking to Bea’s case specifically:  I don’t know whether she would’ve been eligible for the trial when she had chemo (don’t know when the trial started).  The terms of the trial, though, appear not to apply to cases where one has already been treated with chemo in the past.  The success seems to have involved using both agents in some kind of combined regimen, not a sequential process with a time gap, or an evaluation of Herceptin alone. One of the things about being a long(er) term BC survivor, is that as treatments improve, there are things we just miss out on, that could’ve helped us if they’d been known when we were first treated.  It’s scary, but we usually can’t turn back the clock & benefit from the new info. Asking the oncologist can’t hurt, though. Ann T.

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