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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Albain, Kathy S. Carey, Lisa A. Dang, Chau T. Krop, Ian E. Shapira, Iuliana Hudis, Clifford A. Winer, Eric P. Rugo, Hope S. Ellis, Matthew Yardley, Denise A. Wolff, Antonio C. Guo, Hao Overmoyer, Beth A. Barry, William T. Moy, Beverly Marcom, P. Kelly Burstein, Harold J. Partridge, Ann H. Tolaney, Sara M. |
| Description | Author Affiliation: Tolaney SM ( From the Departments of Medical Oncology (S.M.T., B.A.O., A.H.P., I.E.K., H.J.B., E.P.W.) and Biostatistics and Computation Biology (W.T.B., H.G.), Dana-Farber Cancer Institute, and Department of Hematology-Oncology, Massachusetts General Hospital (B.M.) - both in Boston) |
| Abstract | BACKGROUND: No single standard treatment exists for patients with small, node-negative, human epidermal growth factor receptor type 2 (HER2)-positive breast cancers, because most of these patients have been ineligible for the pivotal trials of adjuvant trastuzumab. METHODS: We performed an uncontrolled, single-group, multicenter, investigator-initiated study of adjuvant paclitaxel and trastuzumab in 406 patients with tumors measuring up to 3 cm in greatest dimension. Patients received weekly treatment with paclitaxel and trastuzumab for 12 weeks, followed by 9 months of trastuzumab monotherapy. The primary end point was survival free from invasive disease. RESULTS: The median follow-up period was 4.0 years. The 3-year rate of survival free from invasive disease was 98.7% (95% confidence interval [CI], 97.6 to 99.8). Among the 12 relapses seen, 2 were due to distant metastatic breast cancer. Excluding contralateral HER2-negative breast cancers and nonbreast cancers, 7 disease-specific events were noted. A total of 13 patients (3.2%; 95% CI, 1.7 to 5.4) reported at least one episode of grade 3 neuropathy, and 2 had symptomatic congestive heart failure (0.5%; 95% CI, 0.1 to 1.8), both of whom had normalization of the left ventricular ejection fraction after discontinuation of trastuzumab. A total of 13 patients had significant asymptomatic declines in ejection fraction (3.2%; 95% CI, 1.7 to 5.4), as defined by the study, but 11 of these patients were able to resume trastuzumab therapy after a brief interruption. CONCLUSIONS: Among women with predominantly stage I HER2-positive breast cancer, treatment with adjuvant paclitaxel plus trastuzumab was associated with a risk of early recurrence of about 2%; 6% of patients withdrew from the study because of protocol-specified adverse events. (Funded by Genentech; ClinicalTrials.gov number, NCT00542451.). |
| ISSN | 00284793 |
| e-ISSN | 15334406 |
| Journal | New England Journal of Medicine |
| Issue Number | 2 |
| Volume Number | 372 |
| Language | English |
| Publisher | Massachusetts Medical Society (United States) |
| Publisher Date | 2015-01-08 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Adenocarcinoma Drug Therapy Antibodies, Monoclonal, Humanized Administration & Dosage Antineoplastic Combined Chemotherapy Protocols Therapeutic Use Breast Neoplasms Paclitaxel Chemistry Mortality Therapy Adverse Effects Chemotherapy, Adjuvant Disease-Free Survival Follow-Up Studies Infusions, Intravenous Mastectomy, Segmental Neoplasm Recurrence, Local Radiotherapy Receptor, ErbB-2 Immunology Survival Rate Trastuzumab Clinical Trial Multicenter Study Research Support, Non-U.S. Gov't Medicine |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
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