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Breast Cancer (Expert Forum)
Herceptin following Adriamycin-Cytoxan-Taxol Chemo
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
Herceptin following Adriamycin-Cytoxan-Taxol Chemo
by 7vvvse85p, Dec 29, 2005 12:00AM
My wife underwent a TRAM flap mastectomy in July, 2005 followed by an A/C-T chemo protocol. She was HER2-positive and it has been recommended to her by her oncologist to follow her chemo with a year of Herceptin treatment. Based on the limited knowledge I have, primarily based upon the HERA study I have a couple of questions that someone may be able to help answer for me. We will obviously discuss this in more detail with her oncologist, but I wanted to get a head start on the learning. The Herceptin MAB treatment looks to be a great option for my wife.
1. There seems to be no indication of a termination related to the Herceptin treatment in what I have read. Does the treatment protocol conclude, and what happens once the HER2 protein is no longer blocked by the Herceptin treatments?
2. Would the HER2 protein growth factor become hyper active upon the conclusion of treatment?
3. The tumor was 2.5cm, non-metastatic with no lymph node involvement. My wife is pre-menopausal, would that be an indicator for this treatment?
4. How can one quantify/qualify or guess at the long term effects of this treatment protocol in the absence of additional data?
5. How would I compare the benefits and risks of Herceptin treatment vs. Tamoxifen?
The Herceptin treatment sounds great, but...
Thanks in advance of any insight you might have to offer on this subject of very personal and immediate interest.
1. There seems to be no indication of a termination related to the Herceptin treatment in what I have read. Does the treatment protocol conclude, and what happens once the HER2 protein is no longer blocked by the Herceptin treatments?
2. Would the HER2 protein growth factor become hyper active upon the conclusion of treatment?
3. The tumor was 2.5cm, non-metastatic with no lymph node involvement. My wife is pre-menopausal, would that be an indicator for this treatment?
4. How can one quantify/qualify or guess at the long term effects of this treatment protocol in the absence of additional data?
5. How would I compare the benefits and risks of Herceptin treatment vs. Tamoxifen?
The Herceptin treatment sounds great, but...
Thanks in advance of any insight you might have to offer on this subject of very personal and immediate interest.
Doctor's Answer
by CCF-RN,MSN-JS, Dec 30, 2005 12:00AM
Dear 7vvvse85p, Herceptin (trastuzumab) has been approved by the FDA for treatment of metastatic breast cancer that is HER-2 receptor positive. Recent studies have shown benefit with the use of Herceptin in earlier stages of breast cancer (women with HER-2 positive breast cancer for both node negative and node positive breast cancer) for prolonged disease-free survival. Both premenopausal and postmenopausal women participated in these trials demonstrating benefit. The current information indicates benefit with Herceptin treatment for one year, but studies are ongoing to determine if 2 years of treatment are also beneficial. There is no evidence that the patient’s risk for relapse or tumor activity increases following completion of Herceptin treatment.
Tamoxifen is a hormone therapy used as adjuvant treatment for estrogen receptor positive breast cancer. The treatment with tamoxifen and herceptin would not be an either/or. If your wife's breast cancer is found to be estrogen/progesterone receptor positive then hormone therapy would be considered, whether or not Herceptin was used. Decisions regarding treatments need to be made weighing the risks and benefits of treatment for the individual patient. At this point the planned thorough discussion with your wife's oncologist regarding the risks and benefits of treatments for her specific situation will help with the decision making.
Tamoxifen is a hormone therapy used as adjuvant treatment for estrogen receptor positive breast cancer. The treatment with tamoxifen and herceptin would not be an either/or. If your wife's breast cancer is found to be estrogen/progesterone receptor positive then hormone therapy would be considered, whether or not Herceptin was used. Decisions regarding treatments need to be made weighing the risks and benefits of treatment for the individual patient. At this point the planned thorough discussion with your wife's oncologist regarding the risks and benefits of treatments for her specific situation will help with the decision making.
