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Twelve weeks of paclitaxel with a year of trastuzumab, and no anthracycline, was enough to keep more than 98 percent of women with small node-negative HER2-positive breast cancers free of recurrence at three years.
Single-arm phase 2 study of 406 patients with node-negative HER2-positive breast cancer up to 3 cm treated with weekly paclitaxel for 12 weeks plus trastuzumab for one year.
Three-year invasive disease-free survival was 98.7 percent, with only two distant recurrences, and seven-year follow-up confirmed durable results with minimal cardiac toxicity. It established a de-escalated regimen for stage I disease.
Women with small HER2-positive tumours can avoid anthracyclines and multi-agent chemotherapy; the APT regimen is a guideline standard for stage I HER2-positive disease.
Shares Early HER2-positive breast cancer, Trastuzumab, New England Journal of Medicine.