Trastuzumab Use in Breast Cancer: Clinical Issues

Conclusions

Since there is now a more uniform realization that breast cancer patients will derive benefit from trastuzumab only if the tumor is found to overexpress HER2 either by a 3+ or "unfavorable" IHC result or by a positive FISH test performed by a high-volume laboratory, there should be better discrimination as to which patients should receive the drug. Benefits accrue when the drug is prescribed alone or with a variety of cyto-toxic antitumor agents and possibly hormones. Trastuzumab-associated cardiac disease remains a concern but appears to be a different entity than anthracycline-induced cardiac disease and is often reversible. Issues regarding the length of time that trastuzumab is prescribed after progression of disease are still open.

Adjuvant trials of trastuzumab plus chemotherapy are well underway, with rather reassuring early reports that suggest a low incidence of significant cardiac events. Results from studies that combine trastuzumab with other novel biologic agents are awaited with interest.

The print version of this article was originally certified for CME credit. For accreditation details, contact: H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612. Telephone: (813) 632-1349. Fax: (813) 903-4950. Email: ccjournal@moffitt.usf.edu. URL: http://www.moffitt.usf.edu/pubs/ccj/

Cancer Control. 2002;9(6) © 2002 H. Lee Moffitt Cancer Center and Research Institute, Inc.
© Copyright by H. Lee Moffitt Cancer Center & Research Institute. All rights reserved.

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