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Posted by on Apr 30, 2019 in Breast cancer | 0 comments

In a nutshell

This study investigated if trastuzumab (Herceptin)/paclitaxel (Taxol) reduces the risk of local-regional recurrence (LRR) in patients with HER2-positive breast cancer (BC). 

They found that this treatment reduced LRR risk in HER2-positive patients. 

Some background

Breast cancer (BC) is one of the most common cancers. Treatment for BC depends on a number of factors. One important factor is genetics. Some BC tumor cells express specific proteins. One protein that is commonly expressed is HER2. Tumors that express HER2 are called HER2-positive BC. This type of cancer has an increased risk of recurrence. 

Local regional recurrence (LRR) is when cancer recurs in the same tissue it originated. LRR rates are higher in women with HER2-positive BC. After standard chemotherapy and radiation, HER2-positive patients are usually prescribed trastuzumab. This drug targets the HER2 protein. Patients may also take a chemotherapy drug (such as paclitaxel) in combination with trastuzumab. It is unclear if this treatment protocol improves LRR in HER2-positive BC.

Methods & findings

This study included 406 patients with HER2-positive BC. 272 (67%) patients also had hormone-positive tumors. Surgical treatment options were mastectomy (MT, full removal of the breast) or breast conserving surgery (BCS). BCS patients also had radiotherapy after the removal of the tumor. All patients underwent treatment with trastuzumab and paclitaxel for 12 weeks. Trastuzumab was continued for up to 1 year. 

162 patients underwent a mastectomy. 244 patients underwent BCS. The average follow-up time was 6.5 years after surgery. Survival rate without local recurrence was 98.6% overall. Mastectomy patients had a 7-year survival rate without local recurrence of 98%. BCS patients had a 7-year survival rate without local recurrence of 99%.

The bottom line

The authors concluded that treatment with trastuzumab/paclitaxel reduced LRR risk in HER2-positive patients.

The fine print

There was variability in treatment regimens. More investigation is needed.

Published By :

Breast Cancer Research and Treatment

Date :

Apr 19, 2019

Original Title :

Local-regional recurrence in women with small node-negative, HER2-positive breast cancer: results from a prospective multi-institutional study (the APT trial).

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