Addition of Trastuzumab Doubles Progression-Free Survival in Previously Untreated Advanced HER2/neu Uterine Cancer

Maurie Markman, MD


July 13, 2018

Hello. I am Dr Maurie Markman from Cancer Treatment Centers of American in Philadelphia. I want to briefly discuss a paper that appeared in the Journal of Clinical Oncology.[1] The title of this article is "Randomized Phase II Trial of Carboplatin-Paclitaxel Versus Carboplatin-Paclitaxel-Trastuzumab in Uterine Serous Carcinomas That Overexpress Human Epidermal Growth Factor Receptor 2/neu." This was a very interesting paper, very interesting analysis, and very interesting trial.

We have limited therapeutic options in this subset of patients with advanced uterine cancer. The investigators noted that approximately one third of patients with this condition overexpress HER2. In this trial, patients with documented HER2/neu were randomly assigned to receive carboplatin-paclitaxel or carboplatin-paclitaxel with trastuzumab.

It took a group of 11 academic institutions almost 6 years to complete the trial. Among the 41 patients who previously had not been treated with chemotherapy, there was essentially a doubling of the median time to disease progression, with a hazard ratio of 0.40 (P = .013) in favor of the three-drug arm.

Some may argue that you [need] a randomized phase 3 trial in this setting. If we initiated that trial today, we may have the results in 10 years, maybe a little less. I would strongly argue that the results of this well-conducted, well-analyzed trial, [published] in a high-impact medical journal, should at least [prompt] oncologists who care for patients with this difficult condition to seriously consider the addition of trastuzumab and, if necessary, to discuss with the medical directors of insurance companies why this drug is appropriate to add to the treatment strategy for this patient population.

I strongly encourage you to read this interesting paper if you see women with this condition in your practice. The results are quite important. This is one more important trial to add to the armamentarium of those who strongly believe in the precision medicine approach. In this case, the presence of HER2 overexpression in women with uterine cancer [should persuade oncologists to] consider trastuzumab in the treatment of this difficult condition.

Thank you for your attention.


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