Dr. Budd on Prior Trastuzumab and Paclitaxel Regimens

G. Thomas Budd, MD, Medical Oncologist, Taussig Cancer Center at Cleveland Clinic, Professor, Hematology & Medical Oncology, Case Western Reserve University, discusses prior treatment with trastuzumab and the effect on two regimens of paclitaxel.

The S0221 trial compared two different regimens of paclitaxel for patients with breast cancer. Patients in the trial saw equal benefit from a low-dose regimen of paclitaxel weekly administered for 12 weeks compared with a standard-dose regimen of paclitaxel given every two weeks for 12 weeks with pegfilgrastim support.

The trial, Budd says, was amended to allow the use of trastuzumab in HER2-positive patients. The amendment did not demonstrate an effect on the results. Researchers did analyze any paclitaxel schedule effect in different subsets of patients in the trial, such as those with triple-negative, ER-positive, or HER2-positive disease.

Patients with HER2-positive disease who did not receive prior trastuzumab did seem to benefit slightly more from the every-two-week schedule, though it was a small subset of patients. Budd reinforces the idea that there was no biologic rationale behind this finding.