- 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.
- 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.
- 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.>
- Heterogeneity across studies.
- Small number of studies.