Long-Term Outcomes With Adjuvant Paclitaxel and Trastuzumab in HER2-Positive Breast Cancer
Posted: Tuesday, June 18, 2019
Paclitaxel and trastuzumab were previously shown to be effective against small HER2-positive breast cancer tumors, with a 98.7% disease-free survival rate over a 3-year follow-up period. Now in a planned secondary analysis, the conmbination therapy is 93% effective with a 7-year follow-up. The study was published in the Journal of Clinical Oncology by Sara M. Tolaney, MD, MPH, of the Dana Farber Cancer Institute, and colleagues.
“With longer follow-up, adjuvant paclitaxel and trastuzumab is associated with excellent long-term outcomes,” the authors wrote.
The phase II study included 410 patients with HER2-positive breast cancer with negative nodes and tumors no larger than 3 cm. Most of the study patients (86%) white, with 7% black and 3% Asian.
The researchers looked for genetic factors that may increase patients’ chances of paclitaxel-induced peripheral neuropathy by sequencing the DNA of 230 patients for 51 particular single-nucleotide polymorphisms in the genome.
The 7-year disease-free survival rate was 93%, and the overall survival rate was 95%. There were 23 cases of either cancer recurrence or death: 15 recurrences or new breast cancers, and 8 deaths without any recorded breast cancer recurrence. The authors found one single-nucleotide polymorphism, called rs3012437, to be associated with a higher risk of paclitaxel-induced peripheral neuropathy. The researchers found a tumor subtype distribution similar to that in larger tumors. Of the 278 tumors analyzed, 66% were HER2-enriched, 14% were luminal type B, 13% were luminal type A, and 8% were basal-
“This regimen represents an important step forward in de-escalating therapy to preserve quality of life while achieving excellent outcomes for patients with HER2-positive breast cancer,” the authors concluded.
Disclosure: The study authors’ disclosure information may be found at ascopubs.org.