{"entity":{"id":"paper-apt-tolaney-nejm-2015","kind":"paper","name":"APT: adjuvant paclitaxel and trastuzumab for small, node-negative HER2-positive breast cancer","aka":[],"tldr":"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.\n\nThree-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.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2015","url":"https://doi.org/10.1056/NEJMoa1406281"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/25564897/"}],"tags":[],"related":[],"cancers":["her2-positive-early-breast-cancer"],"sections":[],"technologies":[],"targets":[],"drugs":["trastuzumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2015,"doi":"10.1056/NEJMoa1406281","pmid":"25564897","authors":"Tolaney SM, Barry WT, Dang CT, et al.","paperType":"observational","findings":["Three-year invasive disease-free survival 98.7 percent.","Seven-year disease-free survival 93 percent with 97.5 percent recurrence-free interval."],"whatItMeans":"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."],"changedPractice":true,"participants":406},"route":"/key-papers/paper-apt-tolaney-nejm-2015/","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":"trastuzumab","kind":"drug","name":"Trastuzumab","route":"/drugs/trastuzumab/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}