Breast cancer: short-course trastuzumab less toxic, also less effective

  • Goldvaser H & al.
  • JNCI Cancer Spectr
  • 1 Jun 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • A meta-analysis finds that a shorter course of trastuzumab (

Why this matters

  • Findings suggest that 1 year of trastuzumab should remain the standard of care, along with cardiac monitoring.

Study design

  • Meta-analysis of 6 randomized controlled trials (n=11,603) after search of PubMed and conference abstracts.
  • Funding: None.

Key results

  • Compared with a 1-year course, a shorter trastuzumab course (usually 6 months) is associated with worse DFS (HR, 1.14; P=.003) and worse OS (HR, 1.15; P=.02).
  • In subgroup analysis, the worsening of DFS was unaffected by estrogen receptor status (P=.23), nodal involvement (P=.44), or 9- to 12-week duration of trastuzumab in the experimental group (P=.09).
  • Compared with a 1-year course, a shorter trastuzumab course was associated with 33% lower odds of cardiac dysfunction (OR, 0.67; P<.001 and lower odds of congestive heart failure p=".003).</li">

Limitations

  • Small number of trials.
  • No information on comorbidities or concurrent medications.

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