KEY TAKEAWAYS
- The phase 3 ALTTO trial sub-analysis in small node-negative HER2-positive breast cancer patients explored the long-term outcomes of patients with small node-negative HER2-positive breast cancer treated with adjuvant chemotherapy and anti-HER2 therapy.
- A total of 2821 patients with early HER2-positive breast cancer treated with adjuvant chemotherapy and anti-HER2 therapy were analyzed in a sub-analysis of the ALTTO trial.
- Patients treated with trastuzumab and concomitant chemotherapy had excellent long-term outcomes.
Asub-analysis of the ALTTO trial investigated the long-term outcomes of patients with small node-negative HER2-positive breast cancer, typically managed with adjuvant trastuzumab and paclitaxel. As part of a sub-analysis of the ALTTO trial, 8381 patients with early HER2-positive breast cancer who were treated with adjuvant chemotherapy (anthracycline/taxane- or taxane/carboplatin-based) were randomized to receive trastuzumab (T), lapatinib (L), their sequence (T→L), or their combination (L+T). Patients with tumors of ≤3 Cm and without nodal involvement were included in this sub-analysis.
A group of 2821 patients were studied for 7 years. The patient’s average age was 52, and most had tumors ≤2 cm (64.3%). The 7-year DFS rate was 88.1% (95% CI: 86.7-89.3%). The DFS was not significantly different between treatment groups T, T + L, and T→L, but it was considerably lower for group L (stratified log-rank P = 0.031). The overall survival rate was 95.9% (95% CI: [95.0-96.6%), and the time-to-distant recurrence was 93.4% (95% CI: 92.3-94.4%).
The findings suggested that using trastuzumab and concurrent chemotherapy for patients with small tumors results in excellent long-term outcomes similar to those observed in the APT trial.
Source: https://pubmed.ncbi.nlm.nih.gov/36050448/
Clinical Trial: https://clinicaltrials.gov/ct2/show/NCT00490139/
Nader-Marta G, Debien V, Eiger D, Tsourti Z, Caparica R, Kassapian M, Napoleone S, Hultsch S, Korde L, Wang Y, Chumsri S, Pritchard KI, Untch M, Bellet-Ezquerra M, Dornelles Rosa D, Moreno-Aspitia A, Piccart M, Dafni U, de Azambuja E. Outcomes of patients with small and node-negative HER2-positive early breast cancer treated with adjuvant chemotherapy and anti-HER2 therapy-a sub-analysis of the ALTTO study. Br J Cancer. 2022 Nov;127(10):1799-1807. Doi: 10.108/s41416-022-01963-8. Epub 2022 Sep 1. PMID: 36050448; PMCID: PMC9643324.
