‘RESPECT’ Given to Adjuvant Trastuzumab Monotherapy in Elderly Women With Breast Cancer
Posted: Friday, July 13, 2018
Giving trastuzumab alone as adjuvant therapy after curative surgery, without chemotherapy, may be an option in patients with HER2-positive invasive breast cancer who are aged 70 years or older, according to the results of RESPECT, a phase III randomized controlled trial. The “comparison of restricted mean survival times revealed [that] the lost survival due to omitting chemotherapy was less than 1 month at 3 years,” noted the study authors, led by Masataka Sawaki, MD, PhD, of Aichi Cancer Center Hospital, Nagoya, Japan, who presented their findings at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 510).
Furthermore, the disease-free survival rate at 3 years, the primary endpoint, was 94.8% in the trastuzumab plus chemotherapy arm (n = 131; 12 events) versus 89.2% in the trastuzumab-alone arm (n = 135; 18 events; P= .35). The median follow-up time was 3.52 years. Most patients (median age, 73.5 years) had either stage I (43.6%) or stage IIA (41.7%) breast cancer.
Anorexia (44.3% chemotherapy arm vs. 7.4% trastuzumab-alone arm) and alopecia (71.8% chemotherapy vs. 2.2% trastuzumab-alone) occurred significantly less often in the nonchemotherapy group. Grade 3 or 4 nonhematologic adverse events occurred in 29.8% of the chemotherapy arm versus 11.9% of the trastuzumab-alone arm.
“In light of less toxicity and a better quality-of-life profile, trastuzumab monotherapy can be an option as an adjuvant therapy for elderly HER2-positive [breast cancer] patients,” concluded Dr. Sawaki and colleagues.
