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Neoadjuvant Herceptin helps eradicate HER2-positive breast tumours prior to surgery

 

Several randomised trials indicate that high pathological complete response (pCR) rates (ie, no residual invasive cancer in breast and/or axilla) are achievable with neoadjuvant Herceptin in combination with chemotherapy prior to surgery in patients with HER2-positive breast cancer.

In patients with HER2-positive breast cancer evaluated in the MDACC and NOAH trials, a higher pCR was achieved with Herceptin plus chemotherapy compared with chemotherapy only.1,3

 

Table 2.3 Herceptin reduces the extent of residual breast cancer when given before surgery to patients with HER2-positive breast cancer1,3

 

   

  
In the NOAH trial, pCR rates were doubled when Herceptin was added to neoadjuvant chemotherapy.3

 

In the subgroup of patients in the NOAH trial with HER2-positive inflammatory breast cancer (n=62), Herceptin plus chemotherapy almost tripled pCR rates compared with chemotherapy only.2

 

In the MDACC trial there were no recurrences in patients randomised to chemtherapy plus Herceptin, and estimated disease-free survival at 1 and 3 years was 100%.

 
 

 

  

Figure 2.3 Neoadjuvant Herceptin helps eradicate tumours in patients with HER2-positive inflammatory breast cancer2

 

Results from the GeparQuattro trial of neoadjuvant Herceptin in combination with standard chemotherapy also highlight the efficacy of early treatment of HER2-positive breast cancer, raising the prospect of a cure.

  • Herceptin plus chemotherapy completely eradicated breast tumours in around half of women with HER2-positive EBC.  
  • In contrast, only one fifth of women with HER2-negative disease achieved a pCR with Herceptin plus chemotherapy. 
 

  

Figure 2.4 High pCR rates with neoadjuvant therapy in patients with HER2-positive disease (Herceptin plus chemotherapy) compared with HER2-negative breast cancer (chemotherapy alone)4

 

These trials suggest that neoadjuvant Herceptin in combination with different chemotherapy regimens is effective in minimising large tumours in women with invasive HER2-positive breast cancer, offering the best chance of breast-conserving surgery and increased disease-free survival. 

 

References

  1. Buzdar AU et al. Clin Cancer Res 2007; 13: 228-233.
  2. Baselga J et al. EJC Suppl 2007; 5: 193, abs #O2030.
  3. Gianni L et al. J Clin Oncol (Meeting Abstracts) 2007; 25: 10s, abs 532.
  4. Untch M et al. EJC Suppl 2008; 6: 47, abs 1LB.

Roche Clinical Trials Database

In 2005 Roche launched an electronic clinical trial registry and results database. To learn more about the Herceptin trials, please visit

http://www.roche-trials.com/