Topic: TOPO II TEST

Recently, in their 2007 publication: " American Society of Clinical Oncology 2007 Update of
Recommendations for the Use of Tumor Markers in Breast Cancer"
(JOURNAL OF CLINICAL ONCOLOGY VO L U M E 2 5 N O V E M B E R 2 0 2 0 0 7)

testing for topoisomerase II was discouraged: " the uncertainty regarding the biologic relationship between Topo II protein expression, copy number, proliferation, and benefit from anthracylines makes assessment of Topo II unreliable at this time. " (page 5293)

Additionally you may find the following pertinent for your consideration:

"Sensitivity to Chemotherapy 2007

Level II evidence (prospective therapeutic trials in which marker utility is a secondary study
objective) suggests that overexpression of HER2 (3􏰀 by protein or
􏰁 2.0 FISH ratio by gene amplification) identifies patients who have
greater benefit from anthracycline-based adjuvant therapy. If a clini-
cian is considering chemotherapy for a patient with HER2-positive
breast cancer, it is recommended that an anthracycline be strongly
considered, assuming there are no contraindications to anthracycline
therapy. In the context of trastuzumab therapy, there is Level I evi-
dence (single, high-powered, prospective, randomized controlled tri-
als specifically designed to test the marker or a meta-analyses of well-
designed studies) that a nonanthracycline regimen may produce
similar outcomes.

At present, the Update Committee does not recom-
mend that HER2 be used to guide use of taxane chemotherapy in the
adjuvant setting.

The previous discussion notwithstanding, most correlative
studies have suggested that HER2 amplification and/or overex-
pression identifies those patients in randomized trials who benefit
from anthracycline-based chemotherapy compared with CMF,
while in HER2-negative patients there appears to be no difference
between the two regimens.115,130,131 Thus, given the weight of the
evidence for HER2, it seems prudent to recommend anthracycline-
based adjuvant chemotherapy for a patient with HER2-positive
breast cancer, assuming adjuvant chemotherapy is indicated, the
patient has no contraindication to an anthracycline, and trastu-
zumab administration is not planned. " (page 5293)

The full text of the above (and more) may be read at:

http://jco.ascopubs.org/cgi/reprint/25/33/5287?ijkey=a75a4d93695e979f5051f481ad4240fb61bc7713

Cathy and TomatoJuice, I didn't get the TOPO test either. In my case my oncol was pushing me hard to start therapy. I was 7 or 8 weeks beyond DX and he thought that was getting very near the limit of what he was comfortable with. In my case from all that I had read I really didn't think the test would have changed my decision anyway so there was no need. Glad you are near the end. Also good for you for not postponning the fun things in life in the midst of all this. Distractions are good for the soul.

Thanks for being here...

My onc requested the topoII test for me too, and based on its results, I had TCH.  That was over a year ago. She says that now she wouldn't request the test, but she would STILL have recommended TCH for me.

Janet