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21 Ara 2020

Efforts to improve outcomes beyond those achieved with
1 year of trastuzumab in patients with early-stage
HER2-positive breast cancer are ongoing. Several different
approaches, including extending the duration of
trastuzumab to 2 years (HERceptin Adjuvant [HERA]
trial),5 concurrent or sequential administration of lapatinib,
a tyrosine kinase inhibitor, with trastuzumab (Adjuvant
Lapatinib and/or Trastuzumab Treatment Optimisation
[ALTTO] trial),6 and the addition of bevacizumab, an antiangiogenic
agent, to trastuzumab (Bevacizumab with
Trastuzumab Adjuvant Therapy in HER2-Positive Breast
Cancer [BETH] trial)7 have all been unsuccessful, with no
significant disease-free survival benefit compared with
1 year of trastuzumab. APHINITY (Adjuvant Pertuzumab
and Herceptin in Initial Therapy in Breast Cancer) showed
a significant improvement in invasive disease-free survival
at 3 years from the addition of pertuzumab to trastuzumabbased
adjuvant therapy;8 however, the 3-year reduction in
the percentage of patients with recurrence or death with
pertuzumab was only 1% (pertuzumab group, 94%;
placebo group, 93%).8 Thus, the role of pertuzumab as
adjuvant therapy in HER2-positive breast cancer is a
matter of ongoing debate.9 1 year of trastuzumab added to
adjuvant chemotherapy remains the standard of care for
most patients with early-stage HER2-positive breast
cancer;10,11 however, other phase 3 trials addressing the
same question are in progress. … Read More