What is the role of the STOPHER trial in the treatment of a postmenopausal patient with early-stage, hormone receptor-positive, HER2-negative breast cancer?

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The STOPHER Trial and HR+/HER2- Early Breast Cancer

I cannot identify any trial called "STOPHER" in the provided evidence or in established breast cancer literature. You may be referring to the STOP-HER2 trial (NCT05721248), which is currently recruiting and investigates discontinuation of first-line HER2-targeted therapy in exceptional responders after at least 3 years of treatment 1.

STOP-HER2 Trial Overview

The STOP-HER2 study is designed for HER2-positive metastatic breast cancer patients, not for HR+/HER2-negative disease 1. This trial addresses a fundamentally different patient population than your clinical scenario.

Key Features of STOP-HER2:

  • Study Population: Patients with HER2-positive metastatic breast cancer who have achieved exceptional responses to first-line HER2-targeted therapy (pertuzumab and/or trastuzumab) 1

  • Primary Question: Whether HER2-targeted therapy can be safely discontinued after at least 3 years of treatment in patients with complete or near-complete responses 1

  • Rationale: Retrospective data showed 5-year overall survival rates of 90.5% and 10-year rates of 87% in 33 patients with HER2-positive metastatic breast cancer who had no evidence of disease after ≥5 years of HER2-targeted therapy 1

  • Current Status: Actively recruiting as of 2025 1

Why This Trial Is Not Relevant to HR+/HER2- Disease

HR+/HER2-negative breast cancer does not involve HER2-targeted therapy 2. The treatment paradigm for HR+/HER2-negative disease centers on:

  • Endocrine therapy as the mainstay of treatment 2
  • CDK4/6 inhibitors combined with endocrine therapy for high-risk disease 1, 2
  • Chemotherapy based on stage and tumor biology 2

Standard Adjuvant Approach for Postmenopausal HR+/HER2- Early Breast Cancer:

  • Aromatase inhibitors for 5-10 years are the preferred endocrine therapy 1, 3
  • Extended endocrine therapy beyond 5 years improves outcomes in high-risk patients 1
  • CDK4/6 inhibitors may be added for high-risk early disease based on emerging evidence 2

Common Pitfall to Avoid

Do not confuse HER2-positive and HER2-negative disease management - they represent entirely different treatment algorithms with no overlap in targeted therapy approaches 4, 2. HER2-targeted agents (trastuzumab, pertuzumab) have no role in HER2-negative disease 2.

If you intended to ask about a different trial for HR+/HER2-negative early breast cancer, please clarify the trial name, as no "STOPHER" trial exists in the current literature for this population.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Adjuvant Therapy for Postmenopausal Women with Stage IIIA Breast Cancer

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Treatment Approach for HR+HER2+ Metastatic Breast Cancer

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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