Don Berry: In NeoALTTO & ALTTO Trials, Neoadjuvant Response Predicts Adjuvant

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An article in the June 6 issue of The Cancer Letter described plenary presentations at ASCO 2014. One presentation was the adjuvant breast cancer clinical trial ALTTO in HER2-positive disease, which “was chosen [for the plenary session] because it addressed the reliability of pathological complete response as a surrogate for patient benefit.” The article and much ASCO and post-ASCO rhetoric in the breast cancer community focused on the conclusion that ALTTO failed to show a statistically significant benefit in disease-free survival (DFS) for combination lapatinib/trastuzumab in comparison with trastuzumab, both on a backbone of chemotherapy. This was despite a statistically significant benefit in pathological complete response (pCR) in NeoALTTO, the neoadjuvant version of ALTTO.

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Donald A. Berry
Professor of biostatistics, MD Anderson Cancer Center

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After reading “Breast Cancer Mortality Continues Three-Decade Decline, but Steeper Increases for Women Under 50 & AAPI Women of All Ages,” it is evident that while overall progress is being made in the fight against cancer, concerning disparities remain—particularly within the Native Hawaiian and Pacific Islander (NHPI) communities. 
Donald A. Berry
Professor of biostatistics, MD Anderson Cancer Center

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