Researchers at Jewish General Hospital in Montreal, Quebec, Canada, sought to investigate through a retrospective analysis whether trastuzumab plus vinorelbine is a viable alternative to a taxane plus an anthracycline. Some patients refuse to this standard backbone of chemotherapy regimens for patients with HER2-positive breast cancer because of its common adverse effect of alopecia. In addition, some patients may have a contraindication to receive either of those drugs.
For the study, researchers identified 46 patients with a mean age of 64 years who received trastuzumab plus vinorelbine beetween 2003 and 2010. Most patients received the combination therapy weekly for 6 months, followed by trastuzumab alone for 6 months. Results showed a median 5-year overall survival rate of 94% and a median 5-year cancer-specific survival rate of 98%.
One patient died as a result of febrile neutropenia-induced sepsis. The most common grade 3 or 4 adverse effects included neutropenia, febrile neutropenia, fatigue, and anemia.
The authors report the institutional experience with trastuzumab and vinorelbine (tv), a combination with good clinical activity and a good side effect profile for patients with her2–positive breast cancer. For patients with non–metastatic breast cancer refusing alopecia, or for patients who are not candidates for standard chemotherapy, tv is a reasonable alternative to standard adjuvant chemotherapy.