Herceptin #14/14

The day I’ve been anticipating for almost 1.5 years has finally arrived.  Today’s infusion closed the book on active treatment.  I am now in maintenance and vigilance mode.  I can take a deep breath, knowing I’ve done everything I can to prevent this menacing disease from ever returning.  Totaling 26 infusions in all and representing almost 80 hours in the infusion clinic, my investment of time for adjuvant treatment has been well worthwhile because I have roughly halved the risk of recurrence. I am now free from needles, free from pharmaceuticals, and, I fervently hope, free from cancer.  Free at last!

Herceptin-Chemo: One-Two Punch

Wow, after reading about a recent French retrospective study, I’m feeling even better about having been treated with chemo and Herceptin.  Researchers looked at ~4-year outcomes for 276 breast cancer patients at clinics in France.  This particular cohort of patients was diagnosed with Her2+ breast cancer tumors under 1cm in size and without lymph node involvement (T1abN0).

Within that group, 129 patients underwent Herceptin and chemo, 19 chemo only, 5 Herceptin only, and 123 had no treatment.  The Herceptin-chemo treatment group was notably linked to an initially (that is, prior to treatment) worse prognosis because it represented a larger proportion of hormone receptor negative (ER-, PR-) tumors.  In general, ER/PR- tumors are riskier because patients don’t respond to drugs like Tamoxifen and Femara.

How did they fare?  In the do-nothing group, 13 patients out of 123 relapsed.  In the Herceptin-chemo group, 2 out of 129 patients experienced a recurrence.  A single chemo-only patient and none of the Herceptin-only patients relapsed.  Of the 16 total recurrences over all groups, 9 were distantly located.  In terms of sheer survival, 9 patients from the do-nothing group had died by 40 months compared to a single death from the Herceptin-chemo group.  In summary, even though the patients in the Herceptin-chemo group were expected to do worse, they fared significantly better in both survival and disease-free survival after adjuvant treatment than did the patients who did nothing.

This recent study is significant for me in at least a couple of ways.  First, it bolsters the results from the retrospective Kaiser study that I reported on last year which presented a less dire situation than depicted by other scholarly articles.  Second, though the Her2+ cases represent a small data set (but comparable in size to the Kaiser study’s 237), the probability of disease-free survival for the entire group is 0.94, which is consistent with the Kaiser probability of recurrence for all subjects (with and without adjuvant treatment) of 0.063.  Breaking the French result down, the probability of disease-free survival is 0.98 for the Herceptin-chemo group and 0.89 for the do-nothing group.  If you apply these results to my own T1abN0 case, by enduring 12 months of adjuvant treatment, I reduced the probability of recurrence from 11% down to 2%.