Among women with early, HER2-positive breast cancer, the addition of Herceptin® (trastuzumab) to adjuvant chemotherapy reduces the risk of cancer recurrence and improves survival. Herceptin provides a benefit in combination with either anthracycline- or non–anthracycline-based chemotherapy regimens, but non-anthracycline regimens tend to be less toxic. These results were published in the New England Journal of Medicine.
Twenty to 25 percent of breast cancers overexpress (make too much of) the HER2 protein. HER2-targeted therapies such as Herceptin have dramatically improved outcomes for women with HER2-positive breast cancer, but researchers continue to explore how best to use these therapies.
Herceptin may be used in combination with other common breast cancer treatments such as chemotherapy and hormonal therapy. Use of Herceptin in combination with anthracycline-based chemotherapy, however, has been linked with heart problems in some women.
To explore the combination of Herceptin with anthracycline- and non–anthracycline-based chemotherapy regimens, researchers conducted a study known as BCIRG 006. The study enrolled more than 3,200 HER2-positive breast cancer patients. Patients were assigned to one of three treatment groups:
- Anthracycline-based chemotherapy
- Anthracycline-based chemotherapy plus Herceptin
- Non–anthracycline-based chemotherapy plus Herceptin
The anthracycline-based regimen consisted of doxorubicin, cyclophosphamide, and Taxotere® (docetaxel). The non-anthracycline-based regimen consisted of Taxotere and carboplatin.
- Recurrence rates and overall survival were better in the two Herceptin groups than in the group that did not receive Herceptin.
- The differences in recurrence and survival between the two Herceptin groups were not statistically significant, suggesting that the differences could have occurred by chance alone. This means that the addition of Herceptin to anthracycline-based chemotherapy was not clearly better than the addition of Herceptin to non–anthracycline-based chemotherapy.
- Heart complications were more common among women treated with the anthracycline-based regimen than among women treated with the non–anthracycline-based regimen.
These results confirm that the addition of Herceptin to chemotherapy reduces the risk of recurrence and improves survival among women with early, HER2-positive breast cancer. The results also suggest that the combination of Herceptin with non–anthracycline-based chemotherapy may provide effective cancer control with fewer heart complications.
Reference: Slamon D, Eiermann W, Robert N et al. Adjuvant trastuzumab in HER2-positive breast cancer. New England Journal of Medicine. 2011;365:1273-83.
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