This cost-effective analysis is here to bring you another elusive dominating treatment strategy, this one for the systemic treatment of HER2+ breast cancer. Using enrollees of the KATHERINE trial as a backbone, 5 different neoadjuvant / adjuvant therapy combinations were compared using extrapolations from available clinical trial data. First of all, it’s notable that all 5 sported a price tag well above $400,000. Fortunately, the least expensive also bought the most quality-adjusted life years (QALYs), meaning it dominated in economic speak. TBL: Neoadjuvant paclitaxel + trastuzumab + pertuzumab coupled with adjuvant trastuzumab for patients with a complete response at surgery or dose-dense anthracycline/cyclophosphamide + T-DM1 for those with residual disease were the least expensive strategies (relatively speaking…) that also resulted in the most QALYs. | Kunst, JAMA Netw Open 2020


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