Longer trastuzumab duration ( hera : 2 years vs. 1 year ) showed no improvement in dfs or os and a higher rate of cardiac events .
In the neoadjuvant setting ( neoaltto , GeparQuinto , Neosphere ) , trastuzumab alone or in combination with another anti-her2 agent ( lapatinib , pertuzumab ) was compared with either lapatinib or pertuzumab alone and showed superior or equivalent rates of pathologic complete response .
In the adjuvant setting , lapatinib alone or in combination with trastuzumab , compared with trastuzumab alone ( altto ) or with placebo ( teach ) , was not superior in dfs .
BACKGROUND This systematic review addresses the question " What is the optimal targeted therapy for female patients with early-stage human epidermal growth factor receptor 2 (her2)-positive breast cancer ? "
Four-year follow-up of trastuzumab plus adjuvant chemotherapy for operable human epidermal growth factor receptor 2-positive breast cancer: joint analysis of data from NCCTG N9831 and NSABP B-31.
PURPOSE Trastuzumab is a humanized monoclonal antibody against the human epidermal growth factor receptor 2 ( HER2 ) . The clinical benefits of adjuvant trastuzumab have been demonstrated in interim analyses of four large trials . Initial data of the combined analysis of the North Central Cancer Treatment Group ( NCCTG ) N9831 Intergroup trial and National Surgical Adjuvant Breast and Bowel Project ( NSABP ) B-31 trial were reported in 2005 . Long-term follow-up results on disease-free survival ( DFS ) and overall survival ( OS ) have been awaited . PATIENTS AND METHODS Patients with HER2-positive operable breast cancer were r and omly assigned to doxorubicin plus cyclophosphamide followed by paclitaxel with or without trastuzumab in the NCCTG N9831 and NSABP B-31 trials . The similar design of both trials allowed data from the control and trastuzumab-containing arms to be combined in a joint analysis . RESULTS At 3.9 years of median follow-up , there continues to be a highly statistically significant reduction in DFS event rate in favor of the trastuzumab-containing arm ( P < .001 ) . Similarly , there continues to be a statistically significant 39 % reduction in death rate in favor of the trastuzumab-containing arm ( P < .001 ) . CONCLUSION These data demonstrate consistent DFS and OS advantages of adjuvant trastuzumab over time , with the longest follow-up reported to date . The clinical benefits continue to outweigh the risks of adverse effects
Longer trastuzumab duration ( hera : 2 years vs. 1 year ) showed no improvement in dfs or os and a higher rate of cardiac events .
In the neoadjuvant setting ( neoaltto , GeparQuinto , Neosphere ) , trastuzumab alone or in combination with another anti-her2 agent ( lapatinib , pertuzumab ) was compared with either lapatinib or pertuzumab alone and showed superior or equivalent rates of pathologic complete response .
In the adjuvant setting , lapatinib alone or in combination with trastuzumab , compared with trastuzumab alone ( altto ) or with placebo ( teach ) , was not superior in dfs .
BACKGROUND This systematic review addresses the question " What is the optimal targeted therapy for female patients with early-stage human epidermal growth factor receptor 2 (her2)-positive breast cancer ? "