Dr. Murthy on Caveats of the PERSEPHONE Trial in Breast Cancer

Rashmi K. Murthy, MD
Published: Wednesday, Jul 25, 2018



Rashmi K. Murthy, MD, assistant professor, Department of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses caveats of the PERSEPHONE trial.

Historically, the pivotal adjuvant trials have established 1 year of trastuzumab (Herceptin) as the standard of care in patients with HER2-positive breast cancer. The PERSEPHONE trial was a randomized phase III study that looked at the optimal duration of adjuvant trastuzumab. Over 4,000 patients were enrolled. The trial met its primary endpoint of disease-free survival at 4 years and demonstrated noninferiority with 6 months of adjuvant trastuzumab.

However, Murthy states that it is important to consider the patient population in interpreting the results of the trial. Patients enrolled in the trial did not necessarily receive trastuzumab concurrently with chemotherapy. Approximately 50% of patients received sequential trastuzumab which is not the current standard of care, explains Murthy.

Additionally, high-risk patients did not receive dual HER2-targeted therapy. The chemotherapy backbone was such that not every patient received anthracyclines and taxane chemotherapy. Some patients received taxane-based or anthracycline-based chemotherapy alone.
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Rashmi K. Murthy, MD, assistant professor, Department of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses caveats of the PERSEPHONE trial.

Historically, the pivotal adjuvant trials have established 1 year of trastuzumab (Herceptin) as the standard of care in patients with HER2-positive breast cancer. The PERSEPHONE trial was a randomized phase III study that looked at the optimal duration of adjuvant trastuzumab. Over 4,000 patients were enrolled. The trial met its primary endpoint of disease-free survival at 4 years and demonstrated noninferiority with 6 months of adjuvant trastuzumab.

However, Murthy states that it is important to consider the patient population in interpreting the results of the trial. Patients enrolled in the trial did not necessarily receive trastuzumab concurrently with chemotherapy. Approximately 50% of patients received sequential trastuzumab which is not the current standard of care, explains Murthy.

Additionally, high-risk patients did not receive dual HER2-targeted therapy. The chemotherapy backbone was such that not every patient received anthracyclines and taxane chemotherapy. Some patients received taxane-based or anthracycline-based chemotherapy alone.



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