Researchers in the Herceptin Adjuvant Treatment Trial found that one year of adjuvant treatment with the targeted drug trastuzumab was as effective as two years of initial treatment with surgery, chemotherapy and radiation therapy as necessary in women with early-stage HER2-positive breast cancer. The updated findings were reported at the 2012 European Society of Medical Oncology in Vienna. The Herceptin Adjuvant Trial, administered by Breast Cancer International since 2001, was an international, multicenter, phase III randomized study of 5,102 women with HER2-positive breast cancer. Patients were randomized to receive trastuzumab every three weeks for one year, two years, or as observed after initial surgical treatment, chemotherapy, and medically prescribed radiation therapy. From April 12, 2012, the unadjusted risk ratio for disease recurrence was 0.99 (95% CI 0.85-1.14; p = 0.8588) for female patients with two years of treatment versus one year of treatment, reported Professor Richard Gelber, Harvard Medical School and Farber Cancer Institute, Massachusetts, USA. The overall survival was similar for both treatment modalities [HR = 1.05 (95% CI 0.86-1.28; p = 0.6333)]. According to Professor Richard Gelber, the key message in 2012 was that one year of treatment with trastuzumab could maintain the standard of care for patients with early-stage HER2-positive breast cancer. The investigators found that, over a mean follow-up period of 8 years, the durable benefits of one-year trastuzumab treatment in terms of disease-free survival and overall survival remained stable compared to previously reported patients without trastuzumab treatment. Professor Gelber noted that the long-lasting benefits of disease-free survival and overall survival in one-year trastuzumab-treated patients compared to trastuzumab-free patients were very impressive and reassuring to patients. These results show that the benefits of trastuzumab remain stable over time and do not disappear after several years. Patients can be assured that one year of trastuzumab is effective in treating the disease and reduces the risk rate of disease recurrence and death by up to a quarter over treatment without trastuzumab. Although continued trastuzumab treatment for 2 years does not significantly improve prognosis compared to 1 year of treatment, ongoing trials are validating whether the combination of trastuzumab administered with other anti-HER2 agents, such as patuximab or lapatinib, may have better outcomes for patients with HER2-positive early-stage breast cancer. Professor Christoph Zielinski, chairman of the clinical division of oncology at the Medical University of Vienna in Austria, was not involved in this study, but his analysis of the data from the study noted impressive and successful progress in treating patients with early-stage HER2/neu overexpressing breast cancer by using trastuzumab as an adjuvant. However, the question remains as to whether extending treatment to two years would produce better outcomes than one year of treatment. The current trial shows that this is not the case, and the trial justifies the use of adjuvant drugs given to patients with HER2-positive breast cancer in the early stages. In addition, the trial showed that the biological properties of the disease could not be improved by a longer treatment modality after interfering with growth factor signaling for a year during treatment. According to Professor Zielinski, the oncology community is able to ensure that patients receive the best and most cost-effective treatment, weighing the benefits against the costs for the healthcare system. The latter is important because patient relapse of disease does not only lead to suffering and death, but is also a great burden for society. The current data adds evidence to the latter point of how a selected patient can be avoided through an optimal duration of treatment.