"The groundwork of all happiness is health." - Leigh Hunt

Standard of look after HER2-positive breast cancer stays unchanged

June 15, 2023 – For most patients with early-stage HER2-positive breast cancer, standard treatment should remain the identical, in keeping with recent evidence.

Most women with this kind of breast cancer receive the drug trastuzumab along with other therapies and surgery. The usual duration of therapy with trastuzumab is one 12 months. Over the last decade, studies have been conducted to see if similar results might be achieved if trastuzumab is given for a shorter time period.

But on the annual meeting of the American Society of Clinical Oncology, a 10-year update of a long-running study found that the treatment protocol would remain the identical.

“One year of treatment with trastuzumab remains the standard of care,” said study creator Pier Franco Conte, MD, professor of oncology on the University of Padua in Italy, who presented the study results on the meeting.

He also said that girls with more advanced disease, where the cancer has spread to 4 or more lymph nodes, may particularly profit from a 12 months of treatment.

Trastuzumab is a targeted therapy commonly used to treat HER2-positive breast cancer. Since its introduction about 15 years ago, the usual treatment has been to present it together with chemotherapy for a 12 months after surgery to scale back the danger of the cancer coming back.

But like other cancer drugs, trastuzumab could cause uncomfortable side effects, a few of them serious, including possible heart damage. Trastuzumab can be expensive.

In the present study, Conte and his team randomly assigned 1,254 patients with HER2-positive breast cancer to receive either chemotherapy plus 1 12 months of trastuzumab or 9 weeks of trastuzumab. The women were followed for 9 years.

The researchers checked out several outcomes. One of them was disease-free survival, or how long the ladies lived without the cancer coming back. Disease-free survival and overall survival were very similar in each groups. They were also similar in women whose disease had spread to at least one to 3 lymph nodes.

“Numerically, 10-year disease-free survival and overall survival are quite close for long versus short trastuzumab treatment with an average follow-up of 9 years. However, a stratified analysis suggests that patients with four or more positive nodes and stage III disease may have an advantage in both disease-free and overall survival with treatment,” said Conte.

One of the important thing points of this study was to search out out whether a 9-week treatment with trastuzumab is nearly as good as a 1-year treatment. In drug trials, because of this the test product (the 9-week treatment) is not any worse than the product it’s being in comparison with (1-year treatment) by greater than a small, pre-determined amount. But their study didn’t show a profit from short-term treatment with trastuzumab, Conte said.

However, he added that 9 weeks of treatment with trastuzumab “may represent a cost-effective and effective option for patients with low- or intermediate-risk HER2-positive breast cancer living in countries where access to trastuzumab may be problematic.”