The Pharmaceutical Journal
Vol 279 No 7472 p376
6 October 2007

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Continuing trastuzumab after relapse improves survival in advanced breast cancer

Continuing treatment with trastuzumab (Herceptin) improves survival in women with HER-2 positive advanced breast cancer that has relapsed, according to a study reported last week at the European Cancer Conference in Barcelona.

The observational trial investigated a cohort of 221 women with HER-2 positive advanced breast cancer who had been treated with trastuzumab first-line and 117 who had been treated with the drug second-line following disease progression. Nearly three-quarters (74 per cent) of the women who continued to take trastuzumab after disease progression were alive at two year follow-up, compared with 24 per cent of those who stopped taking the drug when their cancer started to progress.

The median overall survival for the trastuzumab-treated group had not yet been reached but was longer than 27.8 months, compared with a median overall survival of 16.8 months for patients who discontinued the drug (P<0.0001).

Commenting on the findings, Nisha Shaunak, breast cancer specialist pharmacist, Royal Marsden Hospital, London, said: “The results give useful information on the benefit of continuing treatment with trastuzumab, even though this is a relatively small, observational study. The study confirms what most consultants are doing anyway, in continuing to treat after disease progression.”

Ms Shaunak noted that trastuzumab shows synergistic activity with a number of chemotherapy drugs. “The strategy of continuing trastuzumab makes sense, because it is switching off the HER-2 pathway while chemotherapy is working in a different way to slow disease progression,” she said.