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Practice Point
Adjuvant chemotherapy for residual disease – HER2-positive breast cancer
Offer trastuzumab emtansine as additional adjuvant treatment for patients with HER2-positive breast cancer who have residual disease after a neoadjuvant taxane-trastuzumab regimen.
In cases of residual invasive disease after completion of neoadjuvant ChT combined with anti-HER2 therapy, adjuvant trastuzumab should be replaced by adjuvant T-DM1, once approved and where available (Level of evidence – 1)
Insufficient evidence for efficacy or benefit does not outweigh the risk or the disadvantages (adverse events, costs, etc.), optional
How this guidance was developed
No evidence-based source recommendation was initially identified for this topic, which was considered an important aspect of care. A practice point was therefore developed using an expert consensus process during the initial phases of Guidance development.
However, findings from the KATHERINE trial have since become available and the recommendation is also informed by the more recent ESMO 2019 clinical practice guidelines (Europe) containing a source recommendation (date of evidence review not reported) that was graded ‘C’ (using ESMO methods adapted from the Infectious Diseases Society of America-United States Public Health Service Grading System) by the guideline authors.
Adjuvant chemotherapy for residual disease – HER2-positive breast cancer
Practice Point
Offer trastuzumab emtansine as additional adjuvant treatment for patients with HER2-positive breast cancer who have residual disease after a neoadjuvant taxane-trastuzumab regimen.
Principles in action
Safe and quality care
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Communication
No evidence-based source recommendation was initially identified for this topic, which was considered an important aspect of care. A practice point was therefore developed using an expert consensus process during the initial phases of Guidance development.
However, findings from the KATHERINE trial have since become available and the recommendation is also informed by the more recent ESMO 2019 clinical practice guidelines (Europe) containing a source recommendation (date of evidence review not reported) that was graded ‘C’ (using ESMO methods adapted from the Infectious Diseases Society of America-United States Public Health Service Grading System) by the guideline authors.