Dr. Cobleigh offers a similarly mixed assessment. It greatly improves quality of life. Overall, only 20 percent of patients responded. That will be the challenge of the next few years-to identify other characteristics of responders. Median duration of response was nine months.
Unpublished data suggest that trastuzumab also significantly increased one-year overall survival.
Response rates with paclitaxel were particularly improved, from 15 percent with paclitaxel alone to 38 percent with paclitaxel plus antibody. So this is a good result for metastatic disease, but there is still a lot of room for improvement. As first-line therapy, trastuzumab is indicated only in combination with paclitaxel. Cardiotoxicity was an important complication of trastuzumab therapy. If there are subtle signals of deterioration in ejection fraction, Dr. Pegram advises, stop trastuzumab and the patient won't suffer cardiac damage.