After Treatment and Local Recurrence Discovered HER2 Positive - 1258495

koal
Posts:29

NSCLC LL Lobe Initially treated with Cyberknife. Local recurrence 18 months later in Hilar Lymph Node treated with external beam radiation and four rounds of Taxol & Carboplatin. Last PET showed NED.
Then discovered that tumor showed HER 2 (Score 2) positive (but not initially tested for it).
Is there any benefit or justification in seeking additional treatment at this time?

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Reply # - August 7, 2013, 07:50 AM

catdander
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Hi koal, I hope you are still doing well and NED. The same still stands from a previous thread where Dr. West said, "There’s no hard rules, as this is a situation that falls in between our well studied situations, but in such cases, I have favored concurrent chemo/radiation in patients who have a local or loco-regional recurrence after surgery and have no evidence of distant metastatic spread. Radiation alone would have a real potential to be curative, but I think many oncologists would consider chemotherapy, either administered concurrently or sequentially with radiation, could increase the potential for a very good long term outcome." The entire thread can be found here, http://cancergrace.org/topic/hilar-lymph-node-positive-on-pet-scan

As long as you're NED there's only hope with which to treat. :)

You probably know this but you can access your previous threads by clicking on your username, koal.

Janine

Reply # - August 7, 2013, 09:46 PM

Dr West
Posts: 4735

If your question is really about being HER2 positive, the best answer is that there's no established role for treatments against HER2 in lung cancer. It's a great question that we don't know the answer to, but for now, this hasn't been studied in any meaningful way, and there is no clear role, even if it's something that might be considered on an individual basis.

Good luck!

-Dr. West

Reply # - August 7, 2013, 10:20 PM

koal
Posts: 29

Thank you. I discovered I was HER2 positive after I received treatment and was wondering if I might have been treated differently if it was know prior to treatment and or there might be any other options to prevent another recurrence (Herceptin? for instance). As you are so aware, CANCER is a disease that you can't get out of your mind. Thank You for your DEDICATION.

Reply # - August 8, 2013, 07:08 AM

carrigallen
Posts: 194

If I understand you correctly, it seems unclear why your lung tumor slide was tested for HER2 amplification. When tested, about 11% of lung cancers are HER2 IHC 2+ or 3+, but this finding has no current relevance in lung cancer. There were several trials done in the early 2000's looking at Herceptin for HER2-amplified lung cancer, no significant clinical activity was seen.
If you read about HER2 mutations (not amplification), those are a completely different issue.

So it seems like this whole thing may just be a 'red herring'. Hope this helps.

Reply # - August 8, 2013, 07:53 PM

Dr West
Posts: 4735

It's a subject of research now, but it's not nearly as well studied as EGFR or ALK. A recent study published in the Journal of Clinical Oncology reported on a small group of patients with significant HER2 overexpression on their tumors, many of whom seemed to benefit from getting a HER2-directed agent, but that's really the lion's share of information we've got -- no randomized trials, no sense that this is a standard target to look for or that HER2-directed treatment is a standard therapy for lung cancer yet.

-Dr. West

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