Dr. Conte on Outcomes With 1 Year Vs 9 Weeks of Adjuvant Trastuzumab in HER2+ Breast Cancer

Pier Franco Conte, MD, a full professor of oncology at the University of Padova, Italy; director of the Division of Medical Oncology at the Istituto Oncologico Veneto in Padova; and chairman of Rete Oncologica Veneta, discusses long-term outcomes with 1 year vs 9 weeks of treatment with adjuvant trastuzumab (Herceptin) in patients with HER2-positive early breast cancer.

In the phase 3 Short-HER trial (NCT00629278), patients with HER2-positive early breast cancer were randomized to receive chemotherapy plus 9 weeks vs 1 year of adjuvant trastuzumab; this was an investigator-driven, noninferiority trial, with a margin of noninferiority set at a hazard ratio of less than 1.29.

The trial went against the mainstream strategy of intensifying treatment for this patient population, Conte says. The updated disease-free survival and overall survival data confirm the long-term benefit of the shorter dosing regimen in patients with low and intermediate risk factors.

One year of trastuzumab remains the standard in Western countries. However, the 9-week administration should be considered in countries where access to the agent is limited, according to Conte. Financially, a 9-week treatment course could be a better option globally, as many patients worldwide do not have public or private insurance, Conte concludes.