Optimizing the management of HER2-positive early breast cancer: the clinical reality

  • Su. Verma
  • S. Lavasani
  • J. Mackey
  • K. Pritchard
  • M. Clemons
  • S. Dent
  • J. Latreille
  • J. Lemieux
  • L. Provencher
  • Sh. Verma
  • S. Chia
  • B. Wang
  • D. Rayson


Breast cancer positive for HER2 (human epidermal growth factor receptor 2) is associated with a poor prognosis for patients with both early-stage and metastatic breast cancer. Trastuzumab has been shown to be effective and is now considered the standard of care for early-stage patients with HER2-positive breast cancer. In that population, trastuzumab has been studied in six randomized clinical trials. Over­all, use of this agent leads to a significant reduction in risk of disease recurrence and improvement in overall survival. Despite the strong evidence for the use of trastuzumab in managing HER2-positive early breast cancer (EBC), a number of clinical controver­sies remain. The authors of this paper undertook a review of the available scientific literature on adju­vant trastuzumab to produce practical considerations from Canadian oncologists. The panel focused their discussion on five key areas:

  • Management of node-negative disease with tu­mours 1 cm or smaller in size
  • Management of HER2-positive EBC across the spectrum of the disease (that is, nodal and steroid hormone receptor status, tumour size)
  • Timing of trastuzumab therapy with chemotherapy for early-stage disease: concurrent or sequential
  • Treatment duration of trastuzumab for EBC
  • The role of non-anthracycline trastuzumab-based regimens
How to Cite
Verma, S., Lavasani, S., Mackey, J., Pritchard, K., Clemons, M., Dent, S., Latreille, J., Lemieux, J., Provencher, L., Verma, S., Chia, S., Wang, B., & Rayson, D. (1). Optimizing the management of HER2-positive early breast cancer: the clinical reality. Current Oncology, 17(4), 20-33. https://doi.org/10.3747/co.v17i4.700
Medical Oncology