What is the role of trastuzumab in the adjuvant therapy for breast cancer?

Updated: May 21, 2019
  • Author: Erin V Newton, MD; Chief Editor: Neetu Radhakrishnan, MD  more...
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Answer

For patients with HER2 overexpression, the value of adding trastuzumab in the adjuvant setting led to its incorporation into neoadjuvant therapies for patients with the HER2-positive phenotype. This results in higher rates of pathologic complete response (pCR) for operable patients—as high as 65% initially reported by the MD Anderson group—when trastuzumab was given concurrently with an epirubicin (Ellence)-containing program. One preliminary report from a randomized trial in Europe indicates an improvement in pCR rate from 13% to 48% when trastuzumab was added to standard neoadjuvant chemotherapy.

Slamon et al found that adding 1 year of adjuvant trastuzumab therapy significantly improved both disease-free and overall survival among women who had HER2-positive breast cancer. The TCH regimen was preferred over the doxorubicin and cyclophosphamide followed by docetaxel (AC-T) regimen due to fewer toxic effects and lower risks of cardiotoxicity and leukemia. [27]


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