title: Adjuvant trastuzumab: a 10-year overview of its benefit.
abstract: Anti-HER2 targeted therapy is one of the key advances in the treatment of breast cancer that have occurred in the last 20 years. In the adjuvant setting, the use of trastuzumab has led to prolonged and sustained survival benefit with very little toxicity as also confirmed by the 10-year follow-up results from the pivotal trials. Despite the survival improvement, several key issues are not entirely resolved in this field. These issues have led to multiple research efforts in de-escalating or escalating the standard treatment with chemotherapy and 1 year of adjuvant trastuzumab. Areas covered: In this paper, we present an in depth overview on the state of the art on these key issues of refining decision-making in adjuvant anti-HER2 therapy. Expert commentary: Despite many important research efforts in the field, chemotherapy plus trastuzumab for a total duration of 1 year remains the standard of care. However, recent data showed that besides standard anthracycline- and taxane-based cytotoxic therapy, alternative chemotherapy regimens can now be proposed to patients with small tumors without nodal involvement and to women at high-risk of developing cardiotoxicity. Of note, besides HER2 itself, biomarkers predicting patients who may truly benefit from anti-HER2 agents are still lacking.
authors.affiliation: a BrEAST Data Centre, Institut Jules Bordet , l'Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium.|b Breast Cancer Translational Research Laboratory , Institut Jules Bordet , Brussels , Belgium.
authors.forename: Matteo
authors.initials: M
authors.lastname: Lambertini
authors.affiliation: a BrEAST Data Centre, Institut Jules Bordet , l'Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium.
authors.forename: Noam F
authors.initials: NF
authors.lastname: Pondé
authors.affiliation: c Molecular Immunology Unit , Institut Jules Bordet , Brussels , Belgium.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Solinas
authors.affiliation: a BrEAST Data Centre, Institut Jules Bordet , l'Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium.
authors.forename: Evandro
authors.initials: E
authors.lastname: de Azambuja
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D006801:Humans; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors; D015996:Survival Rate; D000068878:Trastuzumab / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: Breast cancer; HER2-positive; adjuvant therapy; chemotherapy; early-stage disease; trastuzumab