HER2+ breast cancer: concurrent trastuzumab + anthracyclines found safe

Access to the full content of this site is available only to registered healthcare professionals. Register to read more


  • Concurrent administration of trastuzumab and anthracyclines is no more cardiotoxic than sequential administration to patients with human epidermal growth factor receptor 2 (HER2) -positive breast cancer.
  • No difference in DFS or OS was reported between groups.

Why this matters

  • Concurrent administration is safe but should be tested in a larger randomized controlled trial (RCT).

Study design

  • In this RCT, patients with HER2+ breast cancer were randomly assigned to concurrent (n=101) or sequential (n=100) administration of trastuzumab (maintenance dose of 6 mg/kg) and anthracyclines (doses at the discretion of physician but cannot exceed 360 mg/m2 doxorubicin and 600 mg/m2 epirubicin).
  • Primary outcome was cardiotoxicity assessed by symptoms, ECG abnormalities, and left ventricular ejection fraction (LVEF) reduction.
  • Median follow-up was 42 months.
  • Funding: Beijing Natural Science Foundation; Beijing Municipal Science and Technology Key Development Program.

Key results

  • No difference was found in cardiotoxicity, with 19.4% meeting criteria for cardiac events in the concurrent group and 22.4% meeting criteria in the sequential group (P=.598).
  • No difference was found in mean LVEF between the 2 groups at 3, 6, 9, 12, and 24 months after the first dose of trastuzumab.
  • Groups showed similar DFS (P=.901) and OS (P=.495).


  • Few patients for survival analysis.