Dr. Extermann on the Utility of Trastuzumab Monotherapy in HER2+ Breast Cancer

Martine Extermann, MD, PhD, professor of oncology and medicine, University of South Florida, program leader, Senior Adult Oncology Program, Moffitt Cancer Center, discusses the utility of single-agent trastuzumab (Herceptin) in HER2-positive breast cancer.

Findings from the phase 3 RESPECT trial (NCT01104935) failed to demonstrate noninferiority with trastuzumab monotherapy compared with trastuzumab plus chemotherapy in older patients with early-stage HER2-positive breast cancer, Extermann says. At 3 years, the estimated relapse-free survival rate was 92.4% with trastuzumab monotherapy compared with 95.3% with trastuzumab plus chemotherapy (HR, 1.33; 95% CI, 0.63-2.79; P = .53). However, patients who received trastuzumab alone had improved quality of life and less adverse effects compared with those who received trastuzumab plus chemotherapy, Extermann explains.

As both regimens yielded high response rates, older patients who are reluctant to receive chemotherapy could be effectively treated with trastuzumab monotherapy without significantly compromising survival, Extermann concludes.