Posted by: bcconnections | October 4, 2012

One year of Herceptin remains the standard of care

The current standard of care for women with HER2-positive, early-stage breast cancer involves treatment with one year of trastuzumab (Herceptin) therapy.  Whether one year is the optimal duration of treatment has remained an open question.  The long-awaited results of the Herceptin Adjuvant (HERA) trial, presented recently at the European Society for Medical Oncology (ESMO) Congress, provide some insight into this question.  The HERA trial enrolled 5,102 women with HER2-positive, early-stage breast cancer.  After completing other necessary treatments (i.e. surgery, chemotherapy, radiation), the women were randomized to one of three groups: observation, one year of Herceptin, or two years of Herceptin.  After eight years of follow-up, the results showed that one year of Herceptin was just as good two years.  There was no significant difference in overall survival or disease-free survival between the one and two year treatment groups.  On the other hand, women in the observation group were 24% more likely to have their breast cancer recur or die from the disease.

Results of the PHARE (Protocol of Herceptin Adjuvant with Reduced Exposure) trial were also presented at the 2012 ESMO meeting.  This trial tested whether six months of Herceptin was as effective as one year for women with HER2-positive breast cancer who were treated with at least four cycles of chemotherapy prior to surgery.  After 42.5 months of follow-up, the results were inconclusive, but suggested that one year was better than six months.  With several other trials ongoing (PERSEPHONE, SHORHER, and SOLD), a conclusive answer to the Herceptin duration question might be determined soon.

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