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[Comment] Optimal duration of trastuzumab for early HER2-positive breast cancer

Four pivotal randomised trials1–3 have shown that the addition of trastuzumab, a monoclonal antibody targeting the HER2 receptor, to adjuvant chemotherapy results in significant improvements in disease-free survival and overall survival for patients with early stage HER2-positive breast cancer. The HERA trial1,4 differed from the North American NSABP B-31 and NCCTG 9831 trials3 because it mandated completion of all adjuvant chemotherapy before administration of trastuzumab, and randomly assigned patients to none, or 1 or 2 years of trastuzumab.