# APT: adjuvant paclitaxel and trastuzumab for small, node-negative HER2-positive breast cancer

Source: https://onco.cc/key-papers/paper-apt-tolaney-nejm-2015/  
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## TL;DR

Twelve weeks of paclitaxel with a year of trastuzumab, and no anthracycline, was enough to keep more than 98 percent of women with small node-negative HER2-positive breast cancers free of recurrence at three years.

## Summary

Single-arm phase 2 study of 406 patients with node-negative HER2-positive breast cancer up to 3 cm treated with weekly paclitaxel for 12 weeks plus trastuzumab for one year.

Three-year invasive disease-free survival was 98.7 percent, with only two distant recurrences, and seven-year follow-up confirmed durable results with minimal cardiac toxicity. It established a de-escalated regimen for stage I disease.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: New England Journal of Medicine
- Year: 2015
- DOI: 10.1056/NEJMoa1406281
- Authors: Tolaney SM, Barry WT, Dang CT, et al.
- Findings: Three-year invasive disease-free survival 98.7 percent.; Seven-year disease-free survival 93 percent with 97.5 percent recurrence-free interval.
- What it means: Women with small HER2-positive tumours can avoid anthracyclines and multi-agent chemotherapy; the APT regimen is a guideline standard for stage I HER2-positive disease.
- Caveats: Non-randomised; the excellent outcomes may partly reflect a favourable population.; Most tumours were under 2 cm and hormone receptor-positive.

## Sources

- N Engl J Med 2015: https://doi.org/10.1056/NEJMoa1406281
- PubMed: https://pubmed.ncbi.nlm.nih.gov/25564897/

## Connected records

- cancers: [Early HER2-positive breast cancer](https://onco.cc/cancers/her2-positive-early-breast-cancer/)
- drugs: [Trastuzumab](https://onco.cc/drugs/trastuzumab/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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