Efforts to improve outcomes beyond those achieved with 1 year of trastuzumab in patients with early-stage HER2-positive breast cancer are ongoing. Several different approaches, including extending the duration of
trastuzumab to 2 years (HERceptin Adjuvant [HERA] trial),5 concurrent or sequential administration of lapatinib, a tyrosine kinase inhibitor, with trastuzumab (Adjuvant Lapatinib and/or Trastuzumab Treatment Optimisation [ALTTO] trial),6 and the addition of bevacizumab, an antiangiogenic agent, to trastuzumab (Bevacizumab with Trastuzumab Adjuvant Therapy in HER2-Positive Breast Cancer [BETH] trial)7 have all been unsuccessful, with no significant disease-free survival benefit compared with 1 year of trastuzumab. APHINITY (Adjuvant Pertuzumab and Herceptin in Initial Therapy in Breast Cancer) showed a significant improvement in invasive disease-free survival at 3 years from the addition of pertuzumab to trastuzumabbased adjuvant therapy;8 however, the 3-year reduction in the percentage of patients with recurrence or death with pertuzumab was only 1% (pertuzumab group, 94%; placebo group, 93%).8 Thus, the role of pertuzumab as adjuvant therapy in HER2-positive breast cancer is a matter of ongoing debate.9 1 year of trastuzumab added to adjuvant chemotherapy remains the standard of care for most patients with early-stage HER2-positive breast cancer;10,11 however, other phase 3 trials addressing the same question … Devamı →
