Herceptin Targets Breast Cancer Stem Cells

Last year I went through breast cancer treatment.My tumors were HER2 positive. I took 4 treatments in a combo of Adriamyacin and Cytoxin. I had a treatment every 2 weeks. Then I had 12 treatments of a combo of Taxol and Herceptin. I finished this in Jan. and had a mastectomy and 9 lymph nodes removed on Feb. 8,2008When I got the pathology report back I was free of cancer. I was told I had a complete response to the chemo and Herceptin.I had a CT scan and PET scan in April and it showed no signs of cancer. So I decided to not take radiation and to just be very dedicated with all follow-up care.

Some patients' tumors respond to chemotherapy and some do not. A pathway/mechanism - cancer stem cells - may be the cause. To prevent cancer's return may require one therapy to shrink a tumor and another therapy to kill the abnormal seeds that sprouted it. Conventional cancer therapies have been good at shrinking tumors, but the ability to shrink tumors has little or no correlation to survival times. Newer treatments need to decrease the number of cancer stem cells.

There is a communication between stem cells and a tumor. It sends out a signal that make the different cells of the tumor and the cancer cells then (send chemical messages) that cycle back to the cancer stem cell. Every tissue and organ in the body is made of cells. In order for cells to grow, divide, or die, they send and receive chemical messages. These messages are transmitted along specific pathways that involve various genes and proteins in a cell.

Finding the protein that prevents cancer from metastasizing, isolating factors within the stem cell microenvironment, can influence tumor cell fate and reverse the cancerous properties of metastatic tumor cells. However, it is not the only tumor suppressive factor within the stem cell microenvironment. Not all genes and proteins have a critical role in the survival and growth of cancer cells.

In some cases, targeted drugs may kill tumor cells without killing microvascular cells in the same time frame. In other cases, they may kill microvascular cells without killing tumor cells. Yet in other cases, they could kill both types of cells or neither type of cells. The ability to these targeted agents to kill tumor and/or microvascular cells in the same tumor is highly variable among the different agents.

You still need to measure the net result of all cellular processes, including interactions, occurring in real time when cancer cells actually are exposed to specific cancer drugs, not just the individual molecular targets. Improving cancer patient diagnosis and treatment through a combination of cellular and gene-based testing will offer predictive insight into the nature of an individual's particular cancer and enable oncologists to prescribe treatment more in keeping with the heterogeneity of the disease.

That's the second time you've cut and pasted from that article, gdp. This time you didn't give the cite, so here's the website it came from.

That information does not in any way diminish the importance of this Herceptin research.

http://www.physorg.com/news134819378.html

Belle, I had the same treatment that you did except that I had surgery first, and I had Taxotere instead of Taxol. I'm also on Femara now, and I'm very glad for all of it. You and I both know we have done everything we can to fight this disease.

I didn't go into it blindly but all the research I found supported my doctor's recommendations.

LOL! Gail, gdpawel is the same as gdpawel. Hello!

Yes, Gregory. that's when I got really curious -- when I found you were posting the same thing all over the Internet. That's not typical. And, in some cases you have included your cites, and in some not. If you don't include the cites you used, that really is plagiarism, although I can understand accidentally leaving them off.

For someone who seems clearly to be a non-medical person, however, you say more than most doctors. I have also seen you misquote people (just plain putting words in Martin Luther King's mouth he never said; his views on science were quite different than what you said here) and over-interpret research. I have doubts about the book you cited; there is no one "disease" called cancer; so we won't be finding "a" cure for it. Cancer names are LOCATIONS, not diseases. Cancer of the brain can be any of a number of things including lung and breast cancer, and even that isn't enough. With that we know it spread from those organs, but there are two common kinds of breast cancer and several more that are more rare. Each one can have a subtype, and for treatment, right now subtype is everything.

By the way, at least for breast cancer they do *not* have a reliable tissue assay test that would tell whether a cancer will respond or not respond to a specific chemo treatment. Cancers are biological entities in their own right, and each cancer has the potential to evolve. In breast cancer, a tumor will often start off responding to a certain chemotherapy -- and then develop a way to fend it off. This is why Tamoxifen (not a chemotherapy) stops working.

I wish it were as simple as finding a test to predict what will work, so right now the best the researchers can do is look at the statistics.

My mother survived breast cancer when she was 38. However, because of her age, she was one of 10% who survived. We really have come a long, long way. It's not perfect but I think the researchers deserve a lot of credit.

About the only thing you and I can agree on is to disagree. Thank you for your diatribe. It was amusing.

gdp, you really don't like being disagreed with, do you? You really did get Martin Luther King ALL wrong, and one of your authors' contention that we should find "a" cure for the disease "cancer" is misguided at best. I think it's a shame that the only answer you can come up with is personal insults. If you had just stopped with "agree to disagree" I wouldn't have had any problem with your response.

Gail, perhaps repeating it over again, it may sink in? "Paraphrase" represents a dynamic equivalent thereof. It conveys the essential thought expressed in a source text at the expense of literality.

Not wanting a real dialog with someone who thrives on intimidation tactics and confrontation is not the same as not wanting someone to disagree with me. Your quote (not mine). "I'm just confronting your misinformation." Again, the quality of my information speaks for itself.

gdp, perhaps reapeating it over again,it may sink in? I'll try to word it more clearly.

You didn'g quote Martin Luther King. You fictionalized him. I'm just confronting your misinformation, and yes, the (lack of) quality of your information speaks for itself. It's riddled with exaggerations and untruths. I'm as sorry as I can be for what happened to your wife, but it's been known for a very long time what radiation can do to the brain. It's one of the unfortunate facts about radiation to the brain in children, which unfortunately sometimes is necessary to treat children with certain cancers.

I learned about it in a pediatric neuropsychology class in 1990, and it was widely known then. It's a terrible trade-off -- do you want to live with the damage you will expeience? Most people say "Yes, I'll take the chance."

There are no guarantees yet when it comes to most cancer treatments. It's about risk vs. benefit. Unfortunately, for any one person, the risk can be 100% and the benefit 0% but for other people the benefit may be significant enough. Personally for me, whether I continue to take Femara is a decision I reconsider at least weekly. Right now it's 50.1% in favor of continuing and 49.9% in favor of stopping it, so I stay very close to the evolving research. I don't like it, but when one has or has had cancer,one has to hedge one's bets very carefully.

Gail, I think we are on the same page when it comes to thoughts of cancer coming to call on us again.I was really fed up with my oncologist after I had my mastectomy and my surgeon told me I had tissue burn from having so much chemo. My oncologist never did anything when I told her about my fingernails and toenails coming off and my feet being so numb. That was all caused by the Taxol. Every week I was getting Procrit and Nupogen for blood cells. Yet the counts never went up.I never received 1 B12 shot nor was my Thyroid checked.She told me I had to keep my port in, because she wanted me to have 12 more treatments of Herceptin, although I had already taken 12 with the Taxol. So you probably already know that the effects of Herceptin somewhere down the road can cause heart problems. It may take years or never happen at all, but with the Adriamycin I had, my chances are double that it could happen. So when i had my mastectomy, my surgeon took out my port. I never went back to that oncologist, not even for follow-up. I got a new oncologist. He is now trying to get me back to where I was before the chemo. My Thyriod is no longer working, so I'm on med. for that. He is giving me B12 inject. as I'm also taking an OTC B12 supplement. Also an inject. for the neuropathy that the Taxol caused.I'm finally getting my energy back.Oncologist need to know there's more to cancer treatment than just the chemo. They are capable of treating the damage it causes. I'm so glad I found a oncologist that does that. I only wish I had found him first.

I am not bothered by the toenail thing. I figure, that's life. And, I think you'll find that unless you had the Adriamycin and the Herceptin together your risk of heart damage from the Herceptin does not go up. Unfortunately the research standard is one year of Herceptin. I actually had to go off of it for a while because my heart output went down two times in a row. My original output was high which was great but we decided to give it a short break.

I understand what you're saying about the neuropathy. I got a second opinion on the Taxol because I'm a potter and I just couldn't have it affecting my hands. That oncologist (from another city) recommended Taxotere once a week instead of Taxol every other week, which we did. After the eleventh of what would have been 12 treatments I got in the shower the next day and I had numb toes and ice cold feet. I told my doctor that I did not believe that there was any research proving that five months plus one week of chemo was better than five months, and he agreed. That was over a year ago and I still havev numbness in my big toes, but it's not severe and it makes no problems for me.

But they are only capable sometimes of treating any damage from chemo. I got very anemic during chemo -- my original count was 16 and it dropped to 9, a huge difference -- but that was my only problem with it (hair grows back although eight of my toenails never started growing again and one still falls off repeatedly 14 months later).

But -- it beats the alternative. It's not perfect but I am well informed and I know my doctor acted n the best knowledge currently available. I think that's all I can ask.

Nope Gail, I didn't quote Martin Luther King, I paraphrased him.

Thanks to advances in biology and genetics, upcoming and existing technologies for personalizing cancer diagnosis and drug treatments are very real.

The key hurdle for these technologies is overcoming the pharmaceutical industry's prevailing blockbuster economic model of the last twenty years. As one peruses the internet, they can see drug companies and so-called industry experts rush to suggest that personalized medicine and their blockbuster model are incompatible.

Tests to identify individuals most likely to benefit from chemotherapy will certainly cut into their old and antiquated model. Having a bio-marker judge clinical efficacy of a particular drug would limit the drug's "market" significantly. No drug company relishes turning over sizable pieces of profitable business through an act of altruism.

Personalized medicine runs against their prevailing business model. Pharmaceutical companies will try to buck the trend as long as they can, but many realize that personalized treatments are inevitable and are making their way into a new paradigm of cancer treatment.

The pharmaceutical industry will need to transform itself as "business as usual" will no longer be good enough. The old pharma "blockbuster" business model is incompatible with personalized medicine. Diagnostics will almost certainly trump pharmaceutics.

"Nope Gail, I didn't quote Martin Luther King, I paraphrased him."

No, you didn't. He never said anything close to that.

"As one peruses the internet, they can see drug companies and so-called industry experts rush to suggest that personalized medicine and their blockbuster model are incompatible."

Maybe it's all in one's perception. I only finished chemo about a year ago and there is the very real, although small, possibility, that my cancer will come back anyway, so I have paid close attention, and that's not my take on it at all. My take on it is that they personalize it as much as they can, but they are not to the point yet where they can say with any kind of certainty what kind of chemotherapy will work for any one person.

There is nothing old and antiquated about using either Herceptin or AI's, and I completely disagree with you on this. At my oncologist's office, treatments are constantly being revised based on the newest research.

There's nothing new about personalized treatments. Treatments are personalized all the time based on the best information currently available. Life-and-death decisions, however, are rarely based on one doctor's opinion or one piece of research.

That said, I would willingly look at the research you have been citing if you are willing to share it.

You can chase your own tail Gail.

I've certainly done that on occasion! But this time, I would like to see the research you keep citing.