Herceptin More Effective If Given with Chemotherapy

Taking Herceptin (trastuzumab) with, as opposed to after, chemotherapy helped more women live longer without a recurrence, according to a phase 3 study presented Saturday at the San Antonio Breast Cancer Symposium.

Investigators randomly assigned roughly 3,000 patients with stage 1 to 3 HER2-positive breast cancer who had already undergone surgery to receive either chemotherapy alone (doxorubicin and cyclophosphamide followed by paclitaxel), chemotherapy followed by Herceptin, or chemotherapy given with Herceptin (paired with paclitaxel). Patients in the Herceptin arms received the drug once a week for a total of one year.

Herceptin after chemotherapy outperformed chemotherapy alone, but simultaneous use proved superior to both. For the 954 women who received Herceptin after chemotherapy, 79.8 percent were alive and free of recurrence after five years. In the 949 women given Herceptin at the same time as chemotherapy, 84.2 percent were recurrence-free at five years—a relative reduction of 25 percent in the risk of recurrence or death.

Since the FDA-approved use of Herceptin allows for either approach, these data suggest Herceptin should be given at the same time as chemotherapy, said lead investigator Edith Perez, MD, of the Mayo Clinic, at a press briefing. Researchers will continue to follow patients to determine whether the positive trend in disease-free survival persists over a longer period of time, she said.

Only about 3 percent of patients in each Herceptin arm experienced cardiac toxicity, a temporary side effect that was managed with appropriate treatment, said Perez. Other side effects of Herceptin can include fever, nausea, and low blood counts.

This article is a part of CURE’s 2009 San Antonio Breast Cancer Symposium coverage. To read more articles from SABCS 2009, visit sabcs2009.curetoday.com.