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HER-2 Gene

TomM1956728
Posts: 64
Joined: Apr 2011

Hello,

I have heard that people who have the HER-2 gene may possibly be able to get more effective treatment.

How do they test a person for the HER-2 gene?  Do they perform a biopsy?

My mother who has esophageal cancer had a biopsy done back in 2011. 

Would they be able to do the test on the biopsy they did back in 2011, or would she have to have a new endoscopy/biopsy done?

Also, if they find out that she has the HER-2 gene, what sort of treatment would they give her. 

I'm assuming that she would have to continue with chemo except that they would give her a different combination of drugs.  Is that correct?

I would greatly appreciate any help on this subject. 

Thank you very much for your kind assistance.

Tom

Dad'sfight
Posts: 155
Joined: Feb 2013

I had my father tested in 1/2013, they used a biopsy they had done in Oct. 2012.  His came back negative, and the doctor told us it was definently worth trying even though very few test postive for it. I don't now how far back they can go to use an old biopsy, but I would definently ask.  What I found out about it was that if you test positive it's because you have too much of the protein HER2 on the cells. They give the medication Herceptin along with chemo to help kill the cells. I think Herceptin can only be given with certain chemo drugs and it's an injection.  I wish your mom the best!!!

 

callerid
Posts: 99
Joined: Dec 2012

My husband is HER 2 positive and takes Herceptin along with his regular chemo infusions. It is considered a targeted therapy.

Josie60's picture
Josie60
Posts: 81
Joined: Jul 2012

I was under the impression that the HER2 gene tended to make the cancer more aggressive, like breast cancer. That is why they add herceptin into the mix.

callerid
Posts: 99
Joined: Dec 2012

You are right in that this gene makes the cancer a more aggressive type. The drug Herceptin works by attaching itself to the HER2 receptors on the surface of cancer cells and block them from receiving growth signals. By blocking the signals, Herceptin can slow or stop the growth of the cancer. Herceptin is considered an immune targeted therapy.

  

eternalife
Posts: 36
Joined: Apr 2013

Yes, Callerid, you are absolutely correct, Herceptin is a targeted therapy specific to HER 2 + cancer patients, It was found useful first in breast ca and now adopted for GI cancer. My husband tested positive for the gene, and has taken Herceptin, however it did not work on the primary site, the esophagus. Not sure why, unfortunately, he was switched to another chemo and now on radiation with one more line of chemo if necessary.

Morale of this  story, targeted therapy does not work on everyone, each cancer victim has their own story to tell.

Best

callerid
Posts: 99
Joined: Dec 2012

How did they determine Herceptin did not work for your husband? My husband was first given, Oxaliplatin, Herceptin and Xeloda. The docotr said it did not appear to work because a lymph node had increased and new metastisis to pelvic bone. He switched him to Docetaxel, and Irinotecan (sp?) but also included Herceptin again for his second line of therapy. So it makes me wonder how your doctor decided it did not work and how they evaluate the effectiveness of each chemical .

Any information would be appreciated

TomM1956728
Posts: 64
Joined: Apr 2011

Thank you Dad'sfight, Callerid, Josie60, and Eternallife.  I learned a lot about the HER-2 Gene and Herceptin.  Unfortunately, the oncologist said that since my mother has squamous cell cancer, the HER-2 gene is very unlikely to be found.  He claims that when it is present, it's usually in the adcarcinoma type cancer so he's not going to test her for the gene.  Thank you all once again.  Tom

 

 

eternalife
Posts: 36
Joined: Apr 2013

Initially my husband was diagnosed with a mass in his right rib and a few lymph nodes with the primary site deemed the esophagus, dec . 2011. He was started on Herceptin with Xeloda and oxaplatin a few months later, no surgery. This chemo therapy line arrested the mass in the lymph and the rib, however the primary continued to thrive. He was then offered ironticanin and folfiri... again the lymph and  the rib remained quiet, however the walls of his esophagus have thickened and the oncologist has now offered chem carboplatin with taxol plus radiation. He is into week 3 of the radiation and we have to endure 2 more weeks and then a wait period before another CT scan to confirm if radiation had any effect. There has been some discussion about surgery, after , of course there is no guarentee on survival rates following surgery, although many on this site remain hopeful, these ones were staged as stages 1-3, for the most part, My husband was staged at a level 4. Not good news...

We were told by the oncologist, that the radiation should be effective, and that his life will be extended, but the cancer is incurable

Anyone with cancer of any type should be careful about saying they're cured, in the early stages.. this is a myth.. Once cancer, always cancer.. the body is weakened and the cells respond accordingly.. stress, genes, the environment all contribute to the beast called cancer.I am not saying this to be mean, that is the truth. Why do some get cancer and others don't.. that's the six million dollar question, I wish scientific research would answer and not the pharmaceuticals.

Take care,

There is hope....

tmclain
Posts: 11
Joined: May 2012

Was found to have a friable, circumferential mass at the GE junction which firm on manipulation. Biopsy showed esophageal adenocarcinoma. Tumor at least invades muscular propria and abuts adventia (T3 disease). Two Para esophageal lymph nodes (N1) Hence, diagnosed with Esophageal Adenocarcinoma with invasion of muscular propria, abutting adventia along with Para esophageal lymph nodes. T3N1 disease. Was enrolled on the RTOG 1010 trial and tested positive for HER2 and was randomized to Trastuzumab + Paclitaxel + Carboplatin arm with concurrent XRT.-Radiation therapy was started 3/6/12. After completing radiation and chemotherapy, on 6/7/12, he underwent surgical resection and esophagectomy.-Per study protocol; he has been started on trastuzumab every 3 weeks post-operatively. He is to Be continued on the trastuzumab to complete 13 treatment doses. My last one was on 3/20/13. My pathology Findings: clean and wide margins micro trace of cancer in 1 out 15 lymph nodes closest to the tumor consider local not distal (good or bad don't know?) Then came my PET SCAN on 10/24/12 with following results: No focal abnormal FDG accumulation is seen in the region of the abdomen and pelvis. No abnormal FDG accumulation is seen in adrenal glands. Bones: No focal abnormal FDG accumulation is seen in the bones. Impression: Whole body PET/CT scan demonstrating no focal abnormal FDG accumulation suspicious Then I had a second PET Scan done in February 2013 and the same results as the frist. Just had my 3rd one today no one called to tell me they found something so I am hopeful it will be the same as the last two. As for the HER-2 treatment I feel like it work very well for me and I am pretty happy about the whole thing they say this combo of drugs work very well. If any knows something about this please post or send me an e-mail.m

tom

DX 1/22/2012 T3N1MO

Trastuzumab + Paclitaxel + Carboplatin + Radiation

paul61's picture
paul61
Posts: 1122
Joined: Apr 2010

Tom,

That sounds like very good news. It appears the combination of traditional treatment and targeted therapy has done the job that you and your medical team hoped it would. I know it has been a difficult journey. I hope the "no news is good news" adage applies to your most recent scan and you get good results from this one as well!!!

Best Regards,

Paul Adams       

Grand Blanc, Michigan

DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009 - Post Surgery Chemotherapy 2/2009 – 6/2009

 

Cisplatin, Epirubicin, 5 FU - Three Year Survivor

eternalife
Posts: 36
Joined: Apr 2013

Thanks for the information on your treatments and results, My husband is on taxel and carboplatin and radiation. He is feeling full and can't eat as much as he use to.  There was some talk about surgery after this treatment cycle, He has just one more week of radiation and then will wait til the scan can be done.

Hoping he will have similar results , he carries the HER 2 gene too.

Keep posting,

goty2001
Posts: 71
Joined: Jul 2012

Her2 used to be bad news - now it is good news thanks to Herceptin.  A soon as I had Her2 diagnosis, I wnt onto Herceptin along with other chemo.  I've since ended all medecine except herceptin, which is keeping my stage IV under control. watch out also for Kadclya (T-DM1)

eternalife
Posts: 36
Joined: Apr 2013

Congrats to your success with Herceptin. I can't say that has been the result for my husband, he took it for one cycle , however it didn't work as well as could, just finished radiation/ chemo.

Waiting now for a scan, likely in 6 weeks or so.

Best to you,

Please keep posting.. you are an inspiration.

I will watch for the other drug.. TD-1, My husband has one more line of chemo he could take... and then....????

dfd24
Posts: 85
Joined: Mar 2011

Hello,

my husband is her2 positive. he had his operation in 2010 and a recurrence in 2012. they only tested him 

2013 for Her2 so he only has received herceptin every three weeks four times so far and folfox every two weeks with it. 

We don't yet know how well it has worked.

Has TDM-1 been approved for esophageal cancer treatment in the US? We are living in Paris France and I don't think it's been approved here yet.

all the best ,

danièle

Joel C's picture
Joel C
Posts: 173
Joined: Mar 2011

I was tested for HER2 after my recurrence over a year after my original diagnoses and only after I ask for the test.  I tested negative but what really bothers me is that it never occurred to these so called experts to test for this gene.  It really makes me wonder how much consideration is actually given to the patient’s best interest Vs profits.

Joel

LauraandLarry's picture
LauraandLarry
Posts: 184
Joined: Sep 2012

Good to hear from you. How are you doing? How about an update? Prayers as always

Joel C's picture
Joel C
Posts: 173
Joined: Mar 2011

Hi Laura,

Thank you for asking about me and the prayers.  Things are going okay but I have been having many bouts of reflux/aspirating when I try to sleep.  It takes a good two or three days to recover from a bad night and having them a couple of time a week means my quality of life is not so great. 

It was disappointing to see your post about Larry having a rough time with his recovery.  Has there been any improvemen?  I remember you mentioned that even with all he is going through he is not depressed.  That really says a lot about his spirit, I give him a lot of credit. 

Take care,

Joel

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