Dr. Rimawi Discusses KATHERINE Trial in HER2+ Breast Cancer

Mothaffar F. Rimawi, MD, an associate professor and director of Clinical Research at the Lester and Sue Smith Breast Center at Baylor College of Medicine, discusses the KATHERINE trial in HER2-positive breast cancer.

In the phase III study, results of which presented at the 2018 San Antonio Breast Cancer Symposium, ado-trastuzumab emtansine (T-DM1; Kadcyla) reduced the risk of invasive disease recurrence or death by 50% compared with trastuzumab (Herceptin) in the adjuvant treatment of patients with HER2-positive breast cancer. These data should be interpreted with optimism and T-DM1 should emerge as the new standard of care in this setting, Rimawi says.

It is important to have a personalized approach and not a “blanket” strategy for all patients, Rimawi says. T-DM1 should be given to patients who closely resemble those enrolled in the trial. Notably, 80% of the patients were treated with trastuzumab first, so an unanswered question that remains in the field is whether the same level of benefit applies to patients treated with pertuzumab (Perjeta) first. There was no signal of difference in the study for the 20% treated with pertuzumab; however, the reality is that there will not be another trial like this, Rimawi notes.