Optimal duration of adjuvant trastuzumab in treatment of early breast cancer: a meta-analysis of randomized controlled trials

Breast Cancer Research and Treatment
Saroj Niraula, Bishal Gyawali

Abstract

One year of adjuvant trastuzumab, chosen empirically, improves survival of women with early-stage, Human Epidermal Growth Factor Receptor 2 (HER2) positive breast cancer. Two years of trastuzumab does not improve efficacy but increases cost, inconvenience, and adverse effects. We aimed to evaluate if less than 1 year of adjuvant trastuzumab retained efficacy while reducing toxicities and cost. We performed a pooled analyses of efficacy and toxicity from Randomized Controlled Trials (RCTs) comparing 1 year of trastuzumab to shorter durations in adjuvant treatment of HER2-positive breast cancer. Hazard Ratios (HR) for Overall Survival (OS) and Disease-Free Survival (DFS), and Odds Ratios (OR) for cardiac events with respective 95% Confidence Intervals (CI) were weighted using generic inverse variance approach and pooled in meta-analyses using random effects models with RevMan 5.3 software. Sub-group analyses of outcomes based on Estrogen Receptor (ER) and nodal status were performed. Five RCTs involving approximately 12,000 patients qualified-three assessing 6 months and two assessing 9 weeks of trastuzumab compared to 1 year. All RCTs were designed to test non-inferiority of the shorter treatment. One year of trastuzumab resulte...Continue Reading

References

Sep 1, 1986·Controlled Clinical Trials·R DerSimonian, N Laird
Feb 2, 2002·Journal of Health Services Research & Policy·Julian HigginsDouglas Altman
Nov 4, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Heikki JoensuuPirkko-Liisa Kellokumpu-Lehtinen
Nov 2, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Edith A PerezRobert B Jenkins
Jul 23, 2013·Lancet·Aron GoldhirschUNKNOWN Herceptin Adjuvant (HERA) Trial Study Team
Jan 4, 2015·BMJ : British Medical Journal·Larissa ShamseerUNKNOWN PRISMA-P Group
May 4, 2015·Annals of Oncology : Official Journal of the European Society for Medical Oncology·D MavroudisUNKNOWN Breast Cancer Investigators of Hellenic Oncology Research Group (HORG), Athens, Greece

❮ Previous
Next ❯

Citations

Feb 13, 2020·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Mariana BrandãoMartine Piccart
Feb 5, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Martine PiccartUNKNOWN APHINITY Steering Committee and Investigators
Oct 15, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Martine J PiccartUNKNOWN BIG-NABCG Collaboration
Nov 26, 2020·Food Research International·María Eléxpuru ZabaletaMaurizio Battino
Mar 30, 2021·The Breast : Official Journal of the European Society of Mastology·Rita De SanctisArmando Santoro
May 7, 2021·Cancer Treatment and Research Communications·Pablo MandóMatías Chacon
Jun 11, 2021·JCO Oncology Practice·Sonia Pernas, Sara M Tolaney

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiotoxicity

Cardiotoxicity refers to the muscle damage or dysfunction of heart electrophysiology caused by drug intake or due to disease complications. It is a well-known side effect of several cytotoxic drugs, especially of the anthracyclines and can lead to long term morbidity. Here is the latest research.

Breast Cancer: Chemo-Resistance

Some cancers are difficult to treat and aggressive including the "triple-negative" breast cancer. This type of cancer is chemoresistant even before chemotherapy begins. Here are the latest discoveries chemo-resistance in breast cancer.