A little respect.

With so many HER2-targeted therapies at our disposal, how aggressive should we be with older women? The RESPECT trial demonstrated that the addition of chemo to trastuzumab alone only minimally improved survival among 275 women with HER2+ breast cancer 70-80 years of ago. Here is the pre-planned secondary analysis asking the real question: discrepancy in quality of life. Among the 231 women evaluable for this substudy, the proportion experiencing the pre-specified decrease in quality of life metrics was significantly lower at 2 months in the group receiving trastuzumab only (31%) versus those also getting chemo (48%) and was halved at 12 months (19% versus 38%). In other words, the significant decrease in quality of life may not be worth the minimal impact of survival gained with the addition of chemo among older women. | Taira, J Clin Oncol 2021