New research published in the October 6, 2011 issue of the New England Journal of Medicine shows that patients with early-stage HER2-positive breast cancer could potentially avoid some of the late-onset cardiac toxicity associated with anthracycline-based therapy (i.e. involving doxorubicin) used with the humanized monoclonal antibody Herceptin (trastuzumab) in the adjuvant setting.
Investigators—led by Dr. Dennis Slamon, the pioneering figure who championed Herceptin in the 1980s and early 1990s when few of his colleagues would do so—randomized a total of 3,222 women diagnosed with HER2-positive early-stage breast cancer into three arms:
-- AC-T: doxorubicin and cyclophosphamide followed by docetaxel every 3 weeks.
-- AC-T + trastuzumab: doxorubicin and cyclophosphamide followed by docetaxel every 3 weeks plus 52 weeks of trastuzumab
-- TCH: docetaxel and carboplatin plus 52 weeks of trastuzumab
The primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS) and safety.
Median follow-up was 65 months, and the estimated disease-free survival rates at 5 years:
-- AC-T: 75 percent
-- AC-T + trastuzumab:84 percent
-- TCH:81 percent
Estimated rates of overall survival:
-- AC-T: 87 percent
-- AC-T + trastuzumab:92 percent
-- TCH: 91 percent
Congestive heart failure and cardiac toxicity issues were found to be much higher in the AC-T + trastuzumab arm than in the TCH arm, while of the handful of secondary leukemias that occurred, all but one were found in the anthracycline-based therapies.
Researchers concluded that adding 52 weeks of trastuzumab "significantly improved disease-free and overall survival among women with HER2-positive breast cancer."
Source
Slamon D et al. Adjuvant Trastuzumab in HER2-Positive Breast Cancer. N Engl J Med 2011; 365:1273-1283 | October 6, 2011.
The information provided on CancerTreatment.net is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her health professional. This information is solely for informational purposes and does not constitute the practice of medicine. We encourage all visitors to see a licensed physician or nutritionist if they have any concerns regarding health issues related to diet, personal image and any other topics discussed on this site. Neither the owners or employees of CancerTreatment.net nor the author(s) of site content take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading this site. Always speak with your primary health care provider before engaging in any form of self treatment. Please see our Legal Statement for further information.
