Shorter Trastuzumab Course Achieves Similar DFS, Less Cardiac Toxicity in HER2+ Breast Cancer

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The following article features coverage from the European Society for Medical Oncology (ESMO) 2018 meeting. Click here to read more news highlights from ESMO 2018.

Current guidelines for treatment of HER2 positive breast cancer is 1 year of anti-HER2 antibody therapy. However, researchers found some women with HER2-positive early breast cancer who have small tumors may achieve similar disease-free survival (DFS) and lower risk of cardiac toxicity with a shorter, 9-week course of adjuvant trastuzumab. These findings were presented at the European Society for Medical Oncology (ESMO) 2018 Congress.

The study was appropriately called the Short-HER trial. For the study, appropriately called the Short-HER trial, 1254 patients with HER2-positive early breast cancer were randomized to 2 groups: One group received trastuzumab for 9 weeks; the other group received trastuzumab for 1 year. Both groups simultaneously received chemotherapy. The results were analyzed after a median 6-year follow-up. Although the 9-week course was not determined to be superior to the 1-year course, it did decrease the risk of severe cardiac toxicity in some patients.

Patients with low and intermediate risk had a similar 5-year disease-free survival with a 9-week course of trastuzumab (88%) as with a 1-year course (89%). In addition, their risk of cardiac events was nearly 3 times lower.

“Physicians can stop trastuzumab before 1 year in patients who develop a cardiac event during treatment without compromising efficacy and can consider shorter-duration trastuzumab treatment in patients at risk of cardiac toxicity and a low or intermediate risk of breast cancer relapse,” explained Pierfranco Conte, professor of oncology at the University of Padua and director of the Division of Medical Oncology at the Instituto Oncologico Veneto, Padua, Italy, and lead study author.

An accompanying study also found that a shorter course (6 months) of adjuvant trastuzumab was more cost-effective for both patients and providers, compared with a 12-month course of treatment.

Reference

Conte PF, Guarneri V, Bisagni G., et. al. 9 weeks versus 1 year adjuvant trastuzumab for HER2+ early breast cancer: subgroup analysis of the ShortHER trial allows to identify patients for whom a shorter trastuzumab administration may have a favourable risk/benefit ratio. Poster presentation at: ESMO 2018 Congress; October 19-23, 2018; Munich, Germany. 

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