9-Week Trastuzumab Course Not Noninferior to Standard Course for HER2+ Breast Cancer, But Does Offer a Benefit

Share this content:
Monitoring patient status in the infusion room.
Monitoring patient status in the infusion room.

For patients with HER2-positive breast cancer, a shorter course of trastuzumab plus chemotherapy may not be superior to the standard 1-year trastuzumab treatment, but it does decrease the risk of severe cardiac toxicity. The final results of the phase 3 randomized Short-HER trial, published in Annals of Oncology, have shown.

Chemotherapy plus 1 year of trastuzumab is the commonly accepted standard adjuvant treatment for HER2-positive breast cancer. The Short-HER trial investigated whether a 9-week course of trastuzumab was comparable to the standard 1-year treatment. The study included 1254 patients with HER2-positive breast cancer who received sequential anthracycline-taxane combinations and were randomized to 1 year or 9 weeks of adjuvant trastuzumab.

The 5-year disease-free survival for patients who underwent 1 year of trastuzumab was 88% vs 85% for those who followed the 9-week course. The 5-year overall survival was 95.2% for the longer course, and 95.0% for the shorter one. However, the shorter course was associated with a significantly lower number of cardiac events compared with the longer one.

Using a statistical inference of probability, the study authors estimated an 80% chance that the 9-week treatment is noninferior to the 1-year treatment. Based on the remaining possibility that the shorter treatment may be inferior, the study authors concluded that a 1-year course of trastuzumab should remain standard. 

“This study failed to show the noninferiority of the shorter trastuzumab administration,” wrote the authors. “However, a 9-week administration decreases the risk of severe cardiac toxicity and can be an option for patients with cardiac events during treatment and for those with a low risk of relapse.” 

Reference

Conte P, Frassoldati A, Bisagni G, et al. Nine weeks versus 1 year adjuvant trastuzumab in combination with chemotherapy: final results of the phase III randomized Short-HER study.Ann Oncol. 2018;29(12):2328-2333.

You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters



Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs