One-Year Trastuzumab with Adjuvant Chemotherapy Provides Benefit

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One year of trastuzumab should be offered to all women with early-stage HER2-positive breast cancer receiving adjuvant chemotherapy.
One year of trastuzumab should be offered to all women with early-stage HER2-positive breast cancer receiving adjuvant chemotherapy.

One year of trastuzumab should be offered to all women with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer who are receiving adjuvant chemotherapy, according to a recent study published in Current Oncology.

Mihaela Mates, MD, FRCPC, of the Cancer Centre of Southeastern Ontario and fellow researchers conducted a meta-analysis of four major trials acquired through Medline and Embase databases from January 2008 to May 2014.

The researchers found that adjuvant trastuzumab for one year was superior in disease-free survival and overall survival compared to no trastuzumab. Shorter duration in one trial demonstrated mixed results in disease-free survival.

Longer trastuzumab duration showed no improvement in either disease-free or overall survival and had a higher rate of cardiac events.

Combination treatment of trastuzumab with other anti-HER2 agents such as lapatinib and pertuzumab compared to either of those agents alone showed superior or equivalent rates of response.

RELATED: Classifying Breast Cancer Subtype May Improve Risk Stratification

There are currently ongoing trials evaluating trastuzumab as a single agent without adjuvant chemotherapy and in patients with low HER2 expression.

“Taking into consideration disease characteristics and patient preference, one year of trastuzumab should be offered to all patients with HER2-positive breast cancer who are receiving adjuvant chemotherapy,” the authors concluded. However, they warned that cardiac function should be regularly monitored in these patients.

Reference

  1. Mates, M., et al. "Systemic targeted therapy for her2-positive early female breast cancer: a systematic review of the evidence for the 2014 Cancer Care Ontario systemic therapy guideline." Current Oncology. DOI: http://dx.doi.org/10.3747/co.22.2322. [epub ahead of print]. March 2015.

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