Debu Tripathy, CURE's editor-in-chief, is in Chicago for the annual meeting of the American Society of Clinical Oncology. He explains the clinical implications of the ALTTO study, which examined Herceptin (trastuzumab), Tykerb (lapatinib), Herceptin and Tykerb, or Herceptin followed by Tykerb. "It essentially showed no statistical difference in the overall disease-free survival rate," he says. "It was a little bit of a disappointment because we obviously want to improve on the benefit of Herceptin alone. And, also, we had early indications that maybe we would see a benefit. There were a series of neoadjuvant trials (so-called pre-operative trials where the chemotherapy is given before surgery) where we compared the number of patients who had a complete disappearance of their tumor. Earlier studies, that were of the same design, had shown that when you combine Herceptin and lapatinib that you nearly doubled the number of patients who had a complete response. We were fairly hopeful that this would translate into a real clinical benefit."While the analysis is not complete, and we still want to examine whether a subgroup of patients benefits, the conclusion now is that Tykerb does not add any benefit to standard Herceptin for early-stage, HER2-positive breast cancer.