Future options with trastuzumab for primary systemic and adjuvant therapy

José Baselga, Luca Gianni, Charles Geyer, Edith A. Perez, Alessandro Riva, Christian Jackisch

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

HER2 positivity can be detected early in breast cancer development and is associated with a poor outcome. Primary systemic therapy with trastuzumab (Herceptin; F. Hoffmann-La Roche, Basel, Switzerland) in combination with taxanes and other cytotoxic agents has been studied in phase II clinical trials in women with HER2-positive breast cancer. These combinations have achieved pathologic complete response rates of 12% to 42% and clinical complete response rates of 30% to 67%. These results compare favorably with those of primary systemic therapy using standard combinations in patients with unselected (HER2-positive or -negative) breast cancer. Consequently, larger studies are in progress in which trastuzumab is administered before surgery in combination with chemotherapy. Trastuzumab is continued as monotherapy afterward to complete 1 year of treatment or until disease progression. These studies aim to provide further proof of the clinical benefits associated with trastuzumab as primary systemic therapy. They will also investigate the molecular determinants of sensitivity and resistance. In addition, four major randomized trials, in more than 13,500 patients, are investigating the impact of adding trastuzumab to standard adjuvant therapy. Planned interim cardiac safety analyses have been passed without concerns. Recruitment to these studies has either recently been completed or continues as planned. Together, this extensive program, which includes analysis of predictive molecular and pathologic makers, will establish the efficacy, safety, and role of trastuzumab in early breast cancer.

Original languageEnglish (US)
Pages (from-to)51-57
Number of pages7
JournalSeminars in oncology
Volume31
Issue numberSUPPL. 10
DOIs
StatePublished - Oct 1 2004

ASJC Scopus subject areas

  • Hematology
  • Oncology

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    Baselga, J., Gianni, L., Geyer, C., Perez, E. A., Riva, A., & Jackisch, C. (2004). Future options with trastuzumab for primary systemic and adjuvant therapy. Seminars in oncology, 31(SUPPL. 10), 51-57. https://doi.org/10.1053/j.seminoncol.2004.07.022