Numerous studies have shown that adding trastuzumab to adjuvant chemotherapy results in about a 50% improvement in disease-free survival and a 33% improvement in overall survival, regardless of the chemotherapy regimen or the sequence of trastuzumab therapy, per Markman and colleagues.
First-line therapy for HER2+ metastatic breast cancer is combination of doublet HER2-targeted agents (pertuzumab/trastuzumab) in combination with a taxane-based chemotherapy.
Neratinib is indicated as a single agent for extended adjuvant treatment following trastuzumab-based therapy.
Trastuzumab in combination with paclitaxel can be used as a frontline treatment in patients with metastatic HER2+ breast cancer, and alone for patients with metastatic disease after one or more prior chemotherapy regimens. It can also be used in combination with chemotherapy for the treatment of certain patients with HER2+ early-stage breast cancer.
The 2016 ASCO guidelines advised that the selection of optimal adjuvant chemotherapy regimens for HER2+ breast cancer should be guided by the risk for recurrence, potential toxicities, comorbidities, and overall likelihood of benefit.
For additional information, refer to the NCCN Clinical Practice Guidelines for Breast Cancer, the 2016 ASCO guidelines, and ESMO Clinical Practice Guideline for the diagnosis, staging, and treatment of patients with metastatic breast cancer.
Learn more about the management of patients with HER2+ breast cancer.
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Cite this: Pavani Chalasani. Fast Five Quiz: HER2+ Breast Cancer - Medscape - Aug 23, 2022.