Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 5 2000
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Audio Below:
Chuck Vogel, at this year’s ASCO, presented a trial in which
if you were FISH positive you had, I think, a 41% response rate
to single agent Herceptin. And, since that is as high an activity
as we see perhaps with virtually any chemotherapeutic agent and
certainly as high as we see with any hormonal therapy, it’s
a reasonable question as to whether or not we might use that as
a single agent, sequential therapy with something else. I’m
a little concerned about doing that, and again, because of the pivotal
trial. And that’s to say that we, to my mind, have some suggestion
that the combination of chemotherapy and Herceptin might be better
than either alone – certainly not from a clean, prospective
trial design like we’d like. Having said that, there are certainly
patients who I’d consider for single agent Herceptin. If the
patient has had multiple prior chemotherapies, I’m likely to
use single agent Herceptin. If the patient has considerable comorbidities
– and outside of clinical trials and in real life many patients
do – I’m likely to use single agent Herceptin. If the
patient has any significant degree of underlying cardiac toxicity,
I’m likely to use single agent Herceptin because we can certainly
see cardiac toxicity with combinations other than adriamycin and
Herceptin. There are groups that I‘ll pick out, primarily based
upon comorbidities, that I’d be willing and likely to give
single agent Herceptin to. But, I think it’s still an important
research question going forward as to whether or not single agent
Herceptin is the equivalent, say, of a combination of Herceptin
and chemotherapy. I should say, whether or not sequential therapy
is the equivalent of combination therapy.
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
