please can anyone tell me why you cant have herceptin unless you had chemo…many thanks
Hi Julie
That’s a really good question - and one I don’t know the answer to - have just added it to list of questions for onc tomorrow - will get back to you !
Hi Jal,
An interesting question indeed but I think the answer is that herceptin works on a specific type of cancer cell - the HER2 protein. The main chemo is needed first or, as in current trials, with herceptin alongside it in order to deal with the whole picture. I found this particular link helpful as it sets it out in fairly simple terms.
breastcancer.org/treatment/targeted_therapies/herceptin/how_it_works.jsp
(Moderator I believe you are happy for this link to be put up?).
dawnhc
Yes I think the answer is that all the trials have used herceptin with chemo (either chemo then herceptin or herceptin and chemo combined.)
I don’t know why there haven’t been any trials just with herceptin?? Christine MH would probably know.
Hope you both get answers from your oncs.
Jane
hi dawn
thanks for the link it was understandable.
take care on this beautiful day
julie
Could it be that as Her 2+ tumours were always seen as more ‘aggressive’ than Her 2- tumours (however my understanding is that this effect is now negated due to the success of Herceptin) then chemo would always be seriously considered for those who are Her 2+ so therefore not many incidences of being offered Herceptin without the chemo?? That is just a my guess, I don’t really know the answer. Great question though.
When I was dx in 2003 the HER2 test was not done at my hospital, albeit a breast care centre of excellence. After reading about HER2 and herceptin on here I contacted my Onc for a test, he said I had to have it done privately, which I did, cost £150 for the consultation and £120 for the test. He told me before the test that even if I was HER2+ he would not prescribe herceptin, as I was “too long out of chemo” - 3 yrs then. He didn’t explain why and I didn’t ask - stupid, I know. He did say that HER2-, along with my ER+ status, was a good prognosis. Luckily the test was HER2-. As others have said, not sure why herceptin must be given either with chemo, or at least within 12 months afterwards.
Asked my onc this question today - her response was that the majority of cases that respond to herceptin have always been agressive cases that additionally require chemo. As a result all the trials to date have been based on chemo + herceptin. However, she did indicate that they were now more aware that there may be instances where herceptin on its own may be effective (even where chemo has been ruled out) and that there is some consideration of trials taking place on this basis -no idea what timescale or if these will ever happen?
Margaret x
Hi Margret
Thanks for that info it was really gt to hear. all my treatment is my insurance so i feel lucky that i am being offered it.
take care.
julie
Lack of trials is key. Also, herceptin seems to make some chemo drugs, like taxotere and carboplatin, more effective, so it makes to give it at the same time as them.