• Oncology · Jan 2001

    Review Randomized Controlled Trial Comparative Study Clinical Trial

    First-line Herceptin monotherapy in metastatic breast cancer.

    • C L Vogel, M A Cobleigh, D Tripathy, J C Gutheil, L N Harris, L Fehrenbacher, D J Slamon, M Murphy, W F Novotny, M Burchmore, S Shak, and S J Stewart.
    • University of Miami School of Medicine, Comprehensive Cancer Research Group, Inc, and Columbia Cancer Research Network of Florida, Miami, Fla, USA.
    • Oncology. 2001 Jan 1; 61 Suppl 2: 37-42.

    AbstractThe pivotal phase II and III Herceptin trials proved the efficacy and safety of second- or third-line single-agent Herceptin and first-line Herceptin in combination with chemotherapy, respectively. In the current trial, 114 patients were randomized to one of two dose groups of first-line Herceptin monotherapy: standard dose of 4 mg/ kg initial dose followed by 2 mg/kg intravenous (i.v.) weekly; or high dose of 8 mg/kg initial dose followed by 4 mg/kg i.v. weekly. The regimen was generally well tolerated. A similar incidence of adverse events was demonstrated in the two dose groups with the possible exception of acute infusion-related events such as fever and chills as well as rash and dyspnea, which appear to be more prevalent in the higher dose group. The overall response rate was 26% and response rates were similar between the two dose groups (24% for the standard Herceptin dose group and 28% for the high Herceptin dose group). Subgroup analysis determined a higher response rate in IHC 3+ patients (35%) and FISH-positive patients (41%). When women with stable disease for > or =6 months were included with responders, the clinical benefit rate in IHC 3+ patients was 47%. Median survival was 24.4 months, which is comparable with the survival rate seen in the pivotal phase III combination trial (25 months). Therefore, single-agent Herceptin is an important new option for the first-line treatment of HER2-positive metastatic breast cancer patients.Copyright 2001 S. Karger AG, Basel

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