Also in the Journals: Before Breast Cancer Surgery, Two Anti-HER2 Drugs May Be Better than One
Women with HER2-positive breast cancer who received both lapatinib (Tykerb) and trastuzumab (Herceptin) fared better than women who received either drug alone in the NeoALLTO trial. The results were reported online January 16 in The Lancet.In the phase III trial, 455 women were randomly assigned to receive trastuzumab, lapatinib, or both drugs combined for a total of 18 weeks prior to surgery. After the first 6 weeks, paclitaxel chemotherapy was added to the anti-HER2 treatments. The researchers found that dual HER2 blockade had significantly greater antitumor effects than those obtained with lapatinib or trastuzumab alone.
About 50 percent of the women who received both anti-HER2 drugs were free of residual cancer in the breast or regional lymph nodes at the time of surgery, compared with fewer than 30 percent of the women who received lapatinib or trastuzumab alone.
These results are consistent with a recent phase II study testing dual HER2 blockade with two anti-HER2 antibodies, trastuzumab and pertuzumab, in the neoadjuvant setting. Both studies provide support for investigating new targeted agents for breast cancer earlier in treatment, “when tumors have not yet acquired resistance to therapy and when chances of clinical benefit are highest,” the study authors noted.
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