Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 5 2000
Play
Audio Below:
If
you look at patients who have had immunohistochemistry – say using
a test such as HercepTest, which was the FDA approved test in this setting
– what we know is that if a patient was considered classically negative
for HercepTest, that’s to say is either a 0 or a 1+ by immunohistochemistry,
there’s pretty good concordance between that and having a negative
FISH test, negative fluorescence in situ hybridization. I think the numbers
are 3% and 7% positivity. If we look at patients who are 3+ by immunohistochemistry,
there’s pretty good concordance between that and being positive for
FISH, there’s a few patients you miss, but not many. However, if
we look at an important intermediate group, that’s to say those patients
who are 2+, only about a quarter of those patients, in fact, are positive
by FISH. Now that makes that a very, very important group to do FISH testing
in. I don’t want to be dogmatic about the other groups because I
think there’s fairly good concordance, but if I have a patient who’s
2+ for immunohistochemistry, I routinely get FISH on that patient, for
a real simple reason. Three-quarters of the time that’s going to
be negative and I’m not going to give that patient Herceptin, I’m
going to avoid both the toxicity of Herceptin and the enormous expense
that one gets with a weekly monoclonal antibody injection. On the other
hand, it could be truly life saving if you’re FISH +, so that patient
routinely will get FISH in my clinic.
Biological
rationale for HER2/neu (c-erbB2) as a target for monoclonal antibody therapy
[Review]. Pegram, M. and Slamon, D Seminars in Oncology. 27(5 Suppl
9):13-19, 2000 Oct.
In
process Current and planned clinical trials with trastuzumab (Herceptin)
[Review]. Baselga, J. Seminars in Oncology. 27(5 Suppl 9):27-32, 2000 Oct. In
process
Clinical
trials of single-agent trastuzumab (Herceptin) [Review]. Seminars in Oncology. 27(5 Suppl 9):20-26, 2000 Oct. In proces
Biological
rationale for HER2/neu (c-erbB2) as a target for monoclonal antibody therapy
[Review]. Pegram, M. and Slamon, D Seminars in Oncology. 27(5 Suppl 9):13-19,
2000 Oct. In
process
The
use of HER2 testing in the management of breast cancer [Review]. Ravdin, P. Seminars in Oncology. 27(5 Suppl 9):33-42, 2000 Oct. In
process
