Dr. Westbrook on 3-Year Follow-Up Data of the KRISTINE Trial in HER2+ Breast Cancer

Kelly E. Westbrook, MD, assistant professor, Duke University School of Medicine, discusses the 3-year follow-up data on the KRISTINE trial in stage II or III HER2-positive breast cancer.

The disease-free survival from the time of surgery for trastuzumab (Herceptin), pertuzumab (Perjeta), docetaxel, and carboplatin (TCHP) versus ado-trastuzumab emtansine (T-DM1; Kadcyla) plus pertuzumab was not significantly different, explains Westbrook. However, event-free survival at 3 years was higher for the TCHP arm at 94.2% versus 85.3% in the T-DM1 plus pertuzumab arm. The Kaplan-Meier curve shows the failure of the T-DM1 plus pertuzumab regimen in the neoadjuvant setting, says Westbrook.

Researchers hypothesize the reason for the T-DM1 plus pertuzumab failure is related to tumor heterogeneity, according to Westbrook. Patients who get T-DM1 plus pertuzumab are only getting therapy that is targeted at the HER2 receptor if there are cells not significantly HER2 overexpressing. There is no chemotherapy backbone in that regimen to offer for treatment of that portion of the tumor, Westbrook concludes.