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Adding pertuzumab after surgery helps women whose cancer had reached the lymph nodes, by a few percentage points, and does not help those with node-negative disease.
APHINITY, trial NCT01358877 sponsored by Roche and the Breast International Group and reported in 2017, showed that adding pertuzumab to trastuzumab and chemotherapy after surgery helps women whose HER2-positive breast cancer had reached the lymph nodes, by a few percentage points, and does not help those with node-negative disease. It randomised 4,805 women and met its primary invasive disease-free survival endpoint at eight years with a modest overall effect, an absolute gain of about five points in node-positive disease and none in node-negative disease, while overall survival was not significantly different, leading to pertuzumab's restriction to higher-risk disease. Whether a few points of disease-free survival justify a year of an expensive antibody is the question it left.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
4,805 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| 8-year invasive disease-free survivalprimary | Pertuzumab arm | 2,400 | 88.4% | 0.78 (0.66 to 0.92) | - | link |
| Placebo arm | 2,405 | 85.8% |
A second publication from the APHINITY trial, later than the first and described in its title as an update or longer-term analysis. Read it with the primary publication linked from the trial page; the record was linked automatically and its figures have not been checked by hand.
Dual HER2 blockade after surgery is reserved for node-positive or otherwise higher-risk disease, where the benefit is real but small; node-negative patients can be spared the extra drug.
Shares Dual HER2 blockade, Pertuzumab, Trastuzumab, HER2-positive breast cancer.
Shares Dual HER2 blockade, Early HER2-positive breast cancer, Pertuzumab, Trastuzumab.
Shares Early HER2-positive breast cancer, Pertuzumab, Trastuzumab, HER2-positive breast cancer.
Shares Early HER2-positive breast cancer, Pertuzumab, HER2-positive breast cancer, Monoclonal antibodies.
Shares Early HER2-positive breast cancer, Pertuzumab, Trastuzumab, HER2-positive breast cancer.
Shares Early HER2-positive breast cancer, Pertuzumab, HER2-positive breast cancer, Monoclonal antibodies.
Shares Early HER2-positive breast cancer, Pertuzumab, Trastuzumab, HER2-positive breast cancer.
Shares Dual HER2 blockade, Pertuzumab, Trastuzumab, HER2-positive breast cancer.