Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 3 2000
Play
Audio Below:
One
of the issues that came up relates to the use of HER2 testing to
select chemotherapy regimens, and here I think perhaps this is one
area where there is still not consensus amongst "experts,"
and I indicated my bias in certain scenarios where node-negative
breast cancers are HER2 overexpressing to incorporate anthracycline
into the regimen. So my bias for AC over CMF for example in those
patients analysis of Venice ABP 11 and B 15 support that. This isn’t
to say that CMF is ineffective ,as the group in Milan showed, but
if a patient understands the magnitude of benefit to be associated
with the use of anthracycline, is cognizant that alopecia will occur
where it might not with CMF, I feel we have developed the bias in
that direction. One interesting question that came up for which
there was consensus amongst experts is that one should not discard
tamoxifen as being less useful for those patients whose tumors are
ER- positive and HER2 neu-positive. The original report from Naples
has, I think, been greatly challenged by larger data sets from the
U.S. – from the CALGB and the NSABP – which suggest that
we should not at all consider tamoxifen not useful in those ER-positive
HER2 neu-positive breast cancers.
