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 ? "
Estimating the magnitude of trastuzumab effects within patient subgroups in the HERA trial.
BACKGROUND Trastuzumab ( Herceptin(R ) ) improves disease-free survival ( DFS ) and overall survival for patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer . We aim ed to assess the magnitude of its clinical benefit for sub population s defined by nodal and steroid hormone receptor status using data from the Herceptin Adjuvant ( HERA ) study . PATIENTS AND METHODS HERA is an international multicenter r and omized trial comparing 1 or 2 years of trastuzumab treatment with observation after st and ard chemotherapy in women with HER2-positive breast cancer . In total , 1703 women r and omized to 1-year trastuzumab and 1698 women r and omized to observation were included in these analyses . Median follow-up was 23.5 months . The primary endpoint was DFS . RESULTS The overall hazard ratio ( HR ) for trastuzumab versus observation was 0.64 [ 95 % confidence interval ( CI ) 0.54 - 0.76 ; P < 0.0001 ] , ranging from 0.46 to 0.82 for subgroups . Estimated improvement in 3-year DFS in subgroups ranged from + 11.3 % to + 0.6 % . Patients with the best prognosis ( those with node-negative disease and tumors 1.1 - 2.0 cm ) had benefit similar to the overall cohort ( HR 0.53 , 95 % CI 0.26 - 1.07 ; 3-year DFS improvement + 4.6 % , 95 % CI -4.0 % to 13.2 % ) . CONCLUSIONS Adjuvant trastuzumab therapy reduces the risk of relapse similarly across subgroups defined by nodal status and steroid hormone receptor status , even those at relatively low risk for relapse
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 ? "