One Equals More Than Two

HER2 positive breast cancer responds best to one year of Herceptin therapy

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Herceptin is the standard medication for treating HER2-positive breast cancer. There has been some question about how long this treatment should last. A new study has answered that question.

One year is the optimum length of time HER2-positive breast cancer patients should be treated with Herceptin. Those are the conclusions of a study that compared one year with two years of treatment.

Longer treatment is associated with an increased risk of heart problems.

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“Giving trastuzumab for a longer duration (two years) did not improve disease-free or overall survival compared with one year of trastuzumab treatment,” said Martine J. Piccart, MD, PhD, chief of the medicine department at the Jules Bordet Institute in Brussels, Belgium, president of the European Society for Medical Oncology and chair of the Breast International Group (BIG), said in a statement.

The study called the HERA trial was an international multi-center trial that followed 5,102 women with HER2-positive early-stage breast cancer for a median of eight years.

Participants were randomly assigned to take Herceptin every three weeks for one or two years, or to be observed without taking the drug. The women had already undergone primary treatment that included surgery, chemotherapy and radiation treatment as needed.

There was no difference in lifespan among the women who received one or two years of treatment. Researchers were looking at both disease-free and overall survival.

The side effect of congestive heart failure was experienced by about the same number of women in both groups. However, cardiac problems that caused no symptoms was more prevalent among the women who took Herceptin for two years – 7.2 percent vs. 4.1 percent in the one-year group.

These events happened while the drug was being given, and most of the problems were resolved once Herceptin was stopped.

Adam Brufsky, MD, PhD, professor of medicine at the University of Pittsburgh School of Medicine, told dailyRx News, “This study is important in that it helps determine the proper length of trastuzumab therapy. When combined with the results of the PHARE [compared 6 months to one-year treatment] trial, it appears that one year of trastuzumab in the adjuvant [after primary treatment] setting may be the optimal length,” said Dr. Brufsky, who was not involved in the study.

Results from the HERA trial were presented December 7 at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium. Breast International Group and Roche, the manufacturer of Herceptin, funded the study. Research findings presented at academic conferences should be considered preliminary until published in a peer-reviewed journal.

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Review Date: 
December 6, 2012
Last Updated:
December 10, 2012