How is Herceptin used differently in the adjuvant setting vs. the metastatic breast cancer setting?
• A: • The goals of adjuvant and metastatic treatment are different. Adjuvant treatment aims to prevent disease recurrence, keeping patients disease-free as long as possible. Treatment of metastatic disease aims to improve the duration of response, prolong time to progression, and palliate symptoms, but it is not curative. • Patient population differs, though HER2 overexpression is required in both settings. Adjuvant treatment is used to treat early-stage, nonmetastatic disease. • Treatment regimens differ: In the adjuvant setting, Herceptin can be given for treatment of HER2- overexpressing node-positive or node-negative (ER/PR-negative or with one high-risk feature*) breast cancer (1) as part of a treatment regimen containing doxorubicin, cyclophosphamide, and either paclitaxel or docetaxel, (2) with docetaxel and carboplatin, or (3) as a single agent following multi-modality anthracycline-based therapy (Herceptin PI, May 2008). In the metastatic setting, Herceptin can be given (1) i
