Dr. Pegram Discusses Adjuvant Pertuzumab in HER2+ Breast Cancer

Mark D. Pegram, MD, Susy Yuan-Huey Hung Professor, co-director, Stanford’s Molecular Therapeutics Program, director, Breast Cancer Oncology Program, Stanford Women’s Cancer Center, discusses the use of adjuvant pertuzumab (Perjeta) in patients with HER2-positive breast cancer.

Pegram says it is a very exciting time for drug development in the HER2-positive breast cancer space. Recent FDA approvals have added to the armamentarium of treatments for early-stage disease.

In December 2017, the FDA approved pertuzumab in combination with trastuzumab (Herceptin) and chemotherapy as an adjuvant treatment for patients with HER2-positive breast cancer. This was based off the results from the phase III APHINITY trial, which demonstrated a 3-year invasive disease-free survival rate of 94.1% with the pertuzumab regimen compared with 93.2% with trastuzumab, chemotherapy, and placebo.

This was a positive study, but the difficulty with the trial is that it was done in a low-risk population, says Pegram. It met its statistical endpoint with confidence, but Pegram says that the absolute benefit of adjuvant pertuzumab is small.