New Trial Results Show that Shorter Duration Of Herceptin (Trastuzumab) Is Effective For Prevention Of Breasts Cancer Return
PERSEPHONE , A new trial study by the University of Warwick and the University Of Cambridge has shown that shortening the duration of a therapy for breast cancer patients does not increase the risk of their cancer returning.
This trial addresses the issues of concerning reduction in the length of treatments and attendant toxicities and whether this can be achieved without any worsening of outcomes.
Clinical trial results show that women treated with 6 months of Herceptin(trastuzumab) for HER2 positive early breast cancer did as well in terms of their risk of breast cancer returning as those getting the currently conventional 12 months treatment. The shorter duration also significantly reduced treatment related side effects, including heart problems.
The PERSEPHONE trial, recruited over 4,088 women with HER2-positive early-stage breast cancer. It compared a six month course of Herceptin with the current standard of twelve months to see whether the shorter treatment was just as effective. This is the largest trial of its kind examining the impact of shortening the duration of Herceptin
The trial showed that 89.4% of patients taking six months treatment were free of breast cancer after four years compared with 89.8% of patients taking treatment for twelve months. These results show that women who took Herceptin for six months fared no worse than patients who had standard 12 months treatment in terms of breast cancer returning. In addition, only 3% of women in the six month arm had to stop taking the drug because of heart problems compared with 8% in the 12 month arm.
Herceptin) has been a huge breakthrough, prolonging and saving the lives of women with breast cancers that carry the HER2 receptor on the surface of their cancer cells. About 18 percent of women with early breast cancers have HER2 positive disease. Herceptin is a targeted therapy that works by attaching to the HER2 receptors preventing the cancer cells from growing and dividing. Based on initial clinical trials a twelve month treatment course was adopted as standard with a requirement for 18 three-weekly injections.
However there were questions raised whether that a shorter duration might be as effective, significantly reducing side effects and cost both to patients and to healthcare systems. Hence this trial was conducted.
The trial included patients who were receiving or going to receive Herceptin as standard for HER2 positive breast cancer. The result indicates there are a large number of patients where a reduced Herceptin treatment duration of six months provides a similar benefit to 12 months without the risk of additional side effects. This data can now be added to all existing data on adjuvant Herceptin to be scrutinized by the wider breast cancer community for consideration of changes to practice. The study does however also suggest that there may be groups where the longer duration is needed to achieve maximum benefit
The trial results give the breast cancer research community an opportunity to reassess how long to give this targeted therapy to patients to see them living longer and with a better quality of life.The important next steps are to work out which patients can stop Herceptin at 6 months and which need extended therapy.
Reference: The Lancet
(2019). DOI: 10.1016/S0140-6736(19)30650-6