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Adding Trastuzumab May Help in Advanced Breast Cancer

Neoadjuvant, adjuvant trastuzumab found to improve three-year event-free survival rate

FRIDAY, Jan. 29 (HealthDay News) -- In women with HER2-positive locally advanced or inflammatory breast cancer, adding neoadjuvant and adjuvant trastuzumab to neoadjuvant chemotherapy may improve event-free survival, according to a study in the Jan. 30 issue of The Lancet.

Luca Gianni, M.D., of the Fondazione IRCCS Istituto Nazionale Tumori in Milan, Italy, and colleagues from the NeOAdjuvant Herceptin (NOAH) trial compared outcomes in 117 patients who received one year of treatment with neoadjuvant and adjuvant trastuzumab in addition to a neoadjuvant chemotherapy regimen consisting of doxorubicin, paclitaxel, cyclophosphamide, methotrexate and fluorouracil, and 118 patients who received neoadjuvant chemotherapy alone.

The researchers found that the three-year event-free survival rate was significantly higher in the trastuzumab group than in the no-trastuzumab group (71 versus 56 percent). They also found that trastuzumab was well tolerated and associated with only two cases of symptomatic cardiac failure, both of which responded to cardiac drugs.

"Although locally advanced breast cancer is relatively infrequent in affluent countries compared with non-affluent countries, it is still an area of medical need, especially in regions of the world where diagnosis tends to occur late for cultural or economic reasons," the authors conclude. "Our results suggest that neoadjuvant trastuzumab should be offered to patients with HER2-positive locally advanced or inflammatory breast cancer alongside neoadjuvant chemotherapy, in addition to the established use of adjuvant trastuzumab postsurgery."

F. Hoffmann-La Roche provided funding and trastuzumab for the study; several authors reported financial relationships with Roche and other pharmaceutical companies.

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