• All patients with HER2 positive breast cancer who require systemic therapy:
    • Should complete 1 year of HER2-targeted therapy:
      • Including those who achieve pathologic complete response after neoadjuvant chemotherapy
  • One could also consider continuing adjuvant pertuzumab in addition to trastuzumab based on results from the phase III Aphinity trial:
    • Although patients who received neoadjuvant chemotherapy were not included in this trial
  • For patients who have residual disease and do not achieve complete pathologic response at the time of surgery:
    • Completion of 1 year of T-DM1:
      • Decreased the risk of recurrence of invasive breast cancer or death by 50% than with trastuzumab alone:
        • Based on results from KATHERINE trial
      • The estimated percentage of patients who were free of invasive disease at 3 years was 88.3% in the T-DM1 group and 77.0% in the trastuzumab group

References

1. von Minckwitz G, Procter M, de Azambuja E, Zardavas D, Benyunes M, Viale G, et al. Adjuvant Pertuzumab and Trastuzumab in early HER2-positive breast cancer N Engl J Med. 2017;377(2):122-131.

2. von Minckwitz G, Huang CS, Mano MS, Loibl S, Mamounas EP, Untch M, et al. Trastuzumab emtansine for residual invasive HER2-positive breast cancer. N Engl J Med. 2019;380(7):617-628.

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