Dr. Perez on the Adjuvant Treatment of Breast Cancer

Edith A. Perez, MD, deputy director, Mayo Clinic Cancer Center, Florida, director, Breast Program, Serene M. and Frances C. Durling Professor of Medicine, Mayo Medical School, reviews clinical trials that are investigating the optimal adjuvant treatment for patients with breast cancer.

Perez details the N9831 trial that studied adjuvant chemotherapy with or without trastuzumab in women with HER2-positive breast cancer. In the trial, patients received doxorubicin plus cyclophosphamide followed by paclitaxel with or without trastuzumab. Results from this trial indicated that administering an anthracycline followed by a taxane plus trastuzumab renders the best results in this setting, Perez explains.

The goal of current adjuvant studies is to determine if dual HER2 inhibition is efficacious. To test this theory, the ALTTO trial is examining the addition of lapatinib to trastuzumab in the adjuvant treatment of HER2-positive metastatic breast cancer. Perez notes that data on this combination is expected within the next year-and-a-half.

Perez mentions that other adjuvant trials are evaluating the combination of trastuzumab and pertuzumab, a HER2 dimerization inhibitor. Additionally, the evaluation of the HER2-targeted antibody-drug conjugate T-DM1 in the adjuvant setting will likely be the focus of future research.