- Earlier initiation of trastuzumab (≤12 weeks from diagnosis) is associated with lower recurrence risk and longer DFS and OS than initiation >12 weeks from diagnosis in patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer (EBC).
Why this matters
- Study supports neoadjuvant trastuzumab over adjuvant trastuzumab.
- Retrospective cohort (n=506) drawn from a large institutional database, the One Thousand HER2 Patients Project.
- Study included stages I-III HER2+ patients with a minimum follow-up of 3 years.
- The date of the first breast biopsy was defined as the time of initial diagnosis.
- Funding: Cancer Clinical Research Trust.
- Median follow-up was 73.3 months.
- Recurrence risk was nearly 2-fold higher in the median time-to-first trastuzumab (mTFT) >12 weeks group than the ≤12 weeks group (HR, 1.96; P=.008).
- 5-year DFS was shorter in the mTFT >12 weeks group (81%; 95% CI, 75%-86%) than the ≤12 weeks group (91%; 95% CI, 86%-94%).
- 5-year OS was shorter in the mTFT >12 weeks group (91%; 95% CI, 86%-94%) than the ≤12 weeks group (97%; 95% CI, 93%-98%).
- The neoadjuvant group had shorter mTFT (4.4 weeks) than the adjuvant group (14 weeks) (P<.00001>
- Retrospective design.