Adjuvant trastuzumab for patients with HER2-positive early breast cancer showed significant improvements in disease-free and overall survival with 12 months of treatment approved in 2006 by the National Institute for Health and Care Excellence in the UK. Single-agent trastuzumab remained the standard of care for those at lower risk of recurrence, and recommendations were made for these patients. This study was aimed to assess current practice and implementation of the PERSEPHONE results by surveying breast oncologists in the UK for their views on the Working Group’s recommendations for 6 months of adjuvant trastuzumab.
Over 78% oncologists agreed that six months of trastuzumab should be a standard option for patients with lower-risk disease receiving single-agent treatment. 97% oncologists responded that patients should be reassured that cessation of trastuzumab at six months would not result in a significant loss of benefit. It is important to recognize that movement towards the de-escalation of therapy is not determined solely by scientific data. The most common reason for not reducing trastuzumab duration was due to waiting for change in guidelines. The UKBCG has issued prioritization guidelines for breast cancer treatments. On the PERSEPHONE data’s strength, the UKBCG executive committee has advised that those at low risk of recurrence receiving single-agent trastuzumab should stop at six months.