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Some people metabolize SSRIs quickly, others slowly, depending on their genetic makeup.
Individuals who metabolize these drugs quickly typically require higher doses because the drug is broken down so quickly, whereas slower metabolizers cannot tolerate large doses.
Thus, women with advanced breast cancer are routinely tested for Her2/neu overexpression before any decisions are made about whether to prescribe Herceptin versus some other drug, because as good as Herceptin might be, to use Hippocrates' words, "the sweet ones do not benefit everyone." There remain some problems, however, with Herceptin and Her2/neu testing, not the least of which is the fact that while the drug works better in Her2-positive patients than it does in Her2-negative patients, only about half of all Her2-positive patients actually benefit from it.
Some scientists say a better test is needed; however, the present test represents the best technology science currently has to offer.
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But even though scientific and industry experts have been predicting the arrival of DNA-based personalized medicine since at least the 1980s and the early days of the In this FISH assay for Her2/neu overexpression in breast cancer tumor cells, the ratio of orange to green signals is used as a measure of gene overexpression. All breast tissue cells are coated with Her2 receptors, but apparently too much of a good thing can be devastating.