{"entity":{"id":"paper-aphinity-nejm-2017","kind":"paper","name":"APHINITY: adjuvant pertuzumab added to trastuzumab and chemotherapy in early HER2-positive breast cancer","aka":[],"tldr":"Adding a second HER2 antibody, pertuzumab, to a year of trastuzumab after surgery reduced recurrences modestly in early HER2-positive breast cancer, with the gain concentrated in women with lymph node involvement.","summary":"Phase 3 placebo-controlled trial of 4,805 patients with operable HER2-positive breast cancer randomised to chemotherapy plus trastuzumab with pertuzumab or placebo for one year.\n\nThree-year invasive disease-free survival was 94.1 percent with pertuzumab against 93.2 percent with placebo (hazard ratio 0.81); in node-positive disease the absolute gain grew to 4.5 percent at six years, with no benefit seen in node-negative disease. Diarrhoea was the main added toxicity.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2017","url":"https://doi.org/10.1056/NEJMoa1703643"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28581356/"}],"tags":[],"related":[],"cancers":["her2-positive-early-breast-cancer"],"sections":[],"technologies":[],"targets":[],"drugs":["pertuzumab","trastuzumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["aphinity"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2017,"doi":"10.1056/NEJMoa1703643","pmid":"28581356","authors":"von Minckwitz G, Procter M, de Azambuja E, et al.","paperType":"rct","findings":["Three-year invasive disease-free survival 94.1 percent vs 93.2 percent; hazard ratio 0.81.","Node-positive subgroup: six-year invasive disease-free survival 87.9 percent vs 83.4 percent."],"whatItMeans":"Dual HER2 blockade after surgery is reserved for node-positive or otherwise higher-risk disease, where the benefit is real but small; node-negative patients can be spared the extra drug.","caveats":["Absolute benefit is small and no overall survival difference has emerged.","Trial predates neoadjuvant therapy as the usual route for stage II to III disease."],"changedPractice":true,"participants":4805},"route":"/key-papers/paper-aphinity-nejm-2017/","neighbours":{"cancer":[{"id":"her2-positive-early-breast-cancer","kind":"cancer","name":"Early HER2-positive breast cancer","route":"/cancers/her2-positive-early-breast-cancer/"}],"drug":[{"id":"pertuzumab","kind":"drug","name":"Pertuzumab","route":"/drugs/pertuzumab/"},{"id":"trastuzumab","kind":"drug","name":"Trastuzumab","route":"/drugs/trastuzumab/"}],"trial":[{"id":"aphinity","kind":"trial","name":"APHINITY","route":"/trials/aphinity/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}