eBCa: 1-year trastuzumab tops shorter course in meta-analysis

  • Chen L & al.
  • Cancer Treat Rev
  • 28 Feb 2019

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

  • 1 year of trastuzumab extends DFS and OS vs shorter courses in a meta-analysis of patients with human epidermal growth factor receptor 2-positive early breast cancer (eBCa).
  • Patients with shorter-duration trastuzumab had 48% fewer cardiac events.

Why this matters

  • 1-year trastuzumab should remain standard of care, but shorter duration may be an alternative for patients with cardiac disease and patients with lower risk of recurrence.

Study design

  • Meta-analysis of 6 randomized controlled trials (n=11,496) after search of Medline, EMBASE, and Cochrane Library.
  • The PHARE and PERSEPHONE trials were included.
  • Shorter-duration trials were either 6 months or 9-12 weeks.
  • Funding: Natural Science Foundation of Guangdong Province, China.

Key results

  • 1-year trastuzumab duration was associated with better DFS (HR, 1.13; P=.01) and OS (HR, 1.16; P=.03) than shorter courses.
  • 1-year trastuzumab with concurrent chemotherapy was tied to 22% improvement in DFS (HR, 1.22; P=.0008; P=.02 for interaction) vs shorter-duration trastuzumab.
  • Shorter-duration trastuzumab was associated with fewer cardiac events (OR, 0.52; P<.00001 than trastuzumab.>

Limitations

  • Heterogeneity across studies.
  • Small number of studies.

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