PracticeUpdate Oncology February 2019

CONFERENCE COVERAGE 22

San Antonio Breast Cancer Symposium 2018 4–8 DECEMBER 2018 • SAN ANTONIO, TEXAS, USA

© MedMeetingImages/Todd Buchanan 2018

Adjuvant T-DM1 for HER2+ Breast Cancer: Critical Data FromThe KATHERINE Study Interview with Jame Abraham MD, FACP by Farzanna S. Haffizulla MD, FACP, FAMWA

improved, and any amount…the really interesting, really exciting finding is patientswith any residual disease, even 5mmor 1 cm, they benefited fromT-DM1. That’s one, and then number two, even low-risk patients like ER+ patients, and about 74% of the patients were ER+, they still bene- fited from T-DM1. So all subsets of patients benefited by switching to T-DM1 instead of continuing trastuzumab if they have residual disease after chemotherapy. Dr. Haffizulla: And we know that this study, as youmen- tioned, focuses on patients with pathologic complete response to neoadjuvant HER2-directed therapy. Why do you think pathologic complete response is such an important prognostic marker? Dr. Abraham: We have prospective randomized trials and meta-analysis of neoadjuvant trials showing that if the patient had a complete pathological response their overall survival is substantially better than the

Dr. Haffizulla: One of the very big studies this year being discussed is a KATHERINE study. Can you tell us a little bit more about the design of the study and maybe some of the objectives of this trial? Dr. Abraham: This is actually a practice-changing study, and we are really happy and impressed at the results of this study. It’s in HER2-patients; about 25% of the patients have HER2 amplification. They received neoadjuvant chemo, then after neoadjuvant chemo with trastuzumab, and some patients had pertuzumab, mainly trastuzumab-containing regimen. If they had residual disease, any amount of invasive residual disease, then they are randomized between T-DM1 versus trastuzumab for 14 doses or a year of treatment. So that’s the scheme of the study. What they found was in patients who are randomized to the T-DM1, the disease-free survival substantially

Dr. Abraham is Director of the Breast Oncology Program at Taussig Cancer Institute and Professor of Medicine at Cleveland Clinic in Cleveland, Ohio.

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