Carboplatin-paclitaxel with or without trastuzumab in HER2-positive advanced or recurrent uterine serous carcinoma
Adding trastuzumab to chemotherapy for HER2-positive uterine serous carcinoma, an aggressive endometrial cancer, lengthened progression-free survival by about four months and later showed a survival benefit, making HER2 testing routine in this subtype.
Overview
Randomised phase 2 trial of 61 women with HER2-positive (immunohistochemistry 3+ or amplified) advanced or recurrent uterine serous carcinoma treated with carboplatin-paclitaxel with or without trastuzumab continued as maintenance.
Median progression-free survival was 12.6 versus 8.0 months (hazard ratio 0.44), with the largest gain in newly diagnosed stage III to IV disease (17.9 versus 9.3 months); an update showed improved overall survival in that group.
- Median progression-free survival 12.6 vs 8.0 months; hazard ratio 0.44.
- Stage III to IV newly diagnosed: 17.9 vs 9.3 months, with an overall survival benefit on update.
HER2 testing of every serous endometrial cancer and trastuzumab with first-line chemotherapy for HER2-positive advanced disease are now guideline recommendations; trastuzumab deruxtecan extends the option.
- Small phase 2 trial.
- About 30 percent of uterine serous carcinomas are HER2-positive; benefit in lower expression is unknown.
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