Dr. Hamilton on the KATHERINE Trial in HER2+ Breast Cancer

Erika P. Hamilton, MD, director, Breast Cancer Program, Sarah Cannon Research Institute, discusses the results of the phase III KATHERINE trial in HER2-positive breast cancer.

The KATHERINE trial accrued patients who did not have a pathologic complete response at surgery after completing neoadjuvant chemotherapy and HER2-targeted therapy. Patients were randomized to receive 14 cycles of adjuvant trastuzumab (Herceptin) or ado-trastuzumab emtansine (T-DM1; Kadcyla).

Results showed a 50% reduction in the risk of invasive disease recurrence or death with T-DM1 versus trastuzumab (HR, 0.50; 95% CI, 0.39-0.64; P <.001).

Despite some toxicity concerns with T-DM1, the agent displays a greater invasive disease-free survival benefit compared with adjuvant neratinib (Nerlynx) or pertuzumab (Perjeta), says Hamilton.

These data suggest that investigators may be able to identify high-risk patients based on their response to neoadjuvant chemotherapy rather than tumor size or nodal status at diagnosis, concludes Hamilton.