Herceptin Appraisal
Herceptin Appraisal NICE have issues the draft Herceptin guidance. Details on the NICE website. Positive for the use of the product .
The way I read it (and it was done quickly this morning) is that 4.6 contains some info on exactly who will get.
Good also to see that the need for further research (short course, scheduling with chemo, optimal chemo and the influence of other factors such as node/receptors ) is also highlighted. (just hope it happens)
Sandra
Hi Sandra Hi Sandra
Thanks for putting up this link.
I am not sure if I am reading the same thing as you but on the 21 page document Final Appraisal determination document 4.6 contained information about node negative people. Being node negative with a tumour of 18mm this obviously interested me. I was advised not to have chemo but that was before my HER2 status was known - I’m now too late to have chemo.
It seems like they are saying that node negative people with a tumour of 1 cm or less probably won’t benefit much from Herceptin but I can’t quite fathom out if they think people with tumours but over 1 cm fall in this category or not.
I didn’t have chemo because of being node-negative - would this now be different and as my tumour was over 1cm I would be advised to have chemo and Herceptin.
I’m well aware that I have “missed the boat” - just still interested though.
bjj
Hummmmmmm
Wording of licence…
Early breast cancer is defined as non-metastatic primary invasive carcinoma of the breast. Early breast cancer in the HERA trial was limited to operable, primary, invasive adenocarcinoma of the breast, with axillary nodes positive or axillary nodes negative if tumours at least 1 cm in diameter.
(full details on www.emc.medicines.org.uk - search herceptin)
So the exact wording /interpretation of the final document will be key (and what I suspect will be the “reason” that the PCT who don’t fund at present will be digging their heels in and waiting for.
From what I’ve been reading on her2support over the last days a “delayed” herceptin arm to HERA exits. SO exactly what when etc. is still complicated.
I
Thanks Hi
Thanks for this.
In section 5.1 it is stated…
“Early breast cancer is defined as non-metastatic primary invasive carcinoma of the breast. Early breast cancer in the HERA trial was limited to operable, primary, invasive adenocarcinoma of the breast, with axillary nodes positive or axillary nodes negative if tumours at least 1 cm in diameter.”
I obviously fall into that category as although I had negative lymph nodes my tumour was over 1cm (1.8 in fact). I think I was in a bit of a grey area at the time of diagnosis (especially as my HER2 status wasn’t known). My guess is that in the future people like me will be advised to have chemo - I wasn’t. I can’t turn the clock back and I do accept that I was advised properly according to the knowledge available.
I’ve been following the “delayed” herceptin arm re HERA trial on the her2 support site. It’s really interesting. If Hercpetin has a positive effect even a few years after chemo then surely it must have some effect even without chemo. Could help people in the future.
Thanks for links.
Love
bjj xx
“I do accept that I was advised properly according to the knowledge available”
Think this sums up what we all need to remember (hard as it is sometimes) - HER2 is a rapidly changing area (think there have also been posts on her2support abut herceptin without chemo. I personally really hope that the finHER type regime - short course combined with chemo is in the longer term found to be the way to go (could rant for hours on this one)
I know it strays from what I orginally posted but I feel really strongly that it isn’t EVER possible to look at one “side” of breast cancer in isolation. It is a multi headed beast. Size/grade/node involvement/receptor status/hormone sensitivity must ALL be taken into account when deciding opitmal treatment for us.
Sandra