Ciara O'Sullivan, MB, BCh
Treatment de-escalation for patients with HER2-positive breast cancer is feasible and imperative, explained Ciara O’Sullivan, MB, BCh, and as the field continues to evolve, more efforts will be directed at tailoring HER2-directed therapies more effectively.
Studies have assessed and confirmed the benefit of de-escalating therapy for patients with early-stage HER2-positive breast cancer. For example, 7-year follow-up data from the APT trial showed that patients with HER2-positive lesions and negative lymph nodes may not necessarily need additional HER2-targeted therapy. Results from the analysis demonstrated a 93.3% disease-free survival rate with the use of adjuvant paclitaxel and trastuzumab (Herceptin) for 12 weeks, followed by 39 weeks of weekly trastuzumab.1
The NSABP B-52 trial evaluated the regimen of docetaxel, trastuzumab, and pertuzumab (Perjeta) alone or in combination with endocrine therapy in patients with hormone receptor–positive, HER2-positive breast cancer. These patients went on to have surgery, with a primary endpoint of pathologic complete response (pCR).
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