Evidence
How we made the decision
Exceptionally, significant new evidence may mean an update of a guideline is agreed before the next scheduled check of the need for an update. The evidence might be a single piece of evidence, an accumulation of evidence or other published NICE guidance.
For details of the process and update decisions that are available, see ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual.
Evidence
A focused search was performed for randomised controlled trials (RCTs) and systematic reviews on adjuvant trastuzumab in adults with early or locally advanced HER2-positive breast cancer, comparing trastuzumab treatment over any designated time period with any shorter period of treatment.
The searches for the current NICE guideline ended in February 2017, but the search strategy used for the review question on trastuzumab would not pick up studies comparing different trastuzumab treatment durations. Therefore, searches were performed from the last date of searches for the first NICE guideline. Search dates were 1 July 2008 to 30 November 2019.
RCTs published on any date during this search period were included. However, to ensure only systematic reviews that included the latest RCTs were identified, systematic reviews were limited to those published in 2019.
RCT sifting was assisted by an automated RCT classifier within EPPI-Reviewer 4 (see user manual for details).
This surveillance report provides an overview of 2 systematic reviews and 12 publications originating from 9 individual RCTs. The results of these studies, alongside topic expert feedback, were considered in detail to determine if there was an impact on the recommendations within the current NICE guideline.
See appendix A for details of all evidence considered, and references.
Views of topic experts
For this exceptional surveillance review, we engaged with topic experts who were recruited to the NICE Centre for Guidelines Expert Advisers Panel to represent their specialty. We received feedback from 3 topic experts (all consultant oncologists with specialist interest in breast cancer).
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