![]() ![]() Modern treatment regimens for human epidermal growth factor receptor 2-positive (HER2+) breast cancer produce favorable long-term outcomes in the vast majority of patients with non-metastatic disease. Planned and ongoing prospective trials will determine the long-term efficacy of this approach. De-escalation of adjuvant chemotherapy among patients who experience pCR in early-stage HER2+ breast cancer is a practicable approach for both patients and physicians. ![]() With brief follow-up (median 19.1 months), there were no breast cancer recurrences. The majority of patients felt positive or neutral about their adjuvant treatment plans. Among patients with pCR, the adherence rate to de-escalated antibody-only therapy (HP) was 98.2% (95% CI 90.3–100.0%), and the primary feasibility endpoint was reached. Five patients had incomplete clinical response following THP and received doxorubicin and cyclophosphamide before surgery they were classified as non-pCR and censored from further analyses. Patients had median age of 50 years, 86% had stage II tumors, and 34% were hormone receptor-negative. Ninety-eight patients received ≥1 dose of THP on study. The primary endpoint was receipt of adjuvant non-HER2-directed cytotoxic chemotherapy. In this single-arm prospective trial, patients with treatment-naïve stage II-III HER2+ breast cancer received neoadjuvant weekly paclitaxel ×12 and HP every 3 weeks ×4. We aimed to assess adherence to de-escalated adjuvant antibody doublet therapy (trastuzumab and pertuzumab, without chemotherapy) among patients with pCR following neoadjuvant paclitaxel/HP (THP). However, the feasibility of this approach and its appeal to patients and providers had not been formally investigated. Npj Breast Cancer volume 8, Article number: 63 ( 2022)ĭe-escalating adjuvant therapy following pathologic complete response (pCR) to an abbreviated neoadjuvant regimen in human epidermal growth factor receptor 2-positive (HER2+) breast cancer is the focus of international research efforts. DOI: 10.1200/JCO.A prospective trial of treatment de-escalation following neoadjuvant paclitaxel/trastuzumab/pertuzumab in HER2-positive breast cancer Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update. Wolff AC, Hammond MEH, Allison KH, et al. Comparison of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) assessment for Her-2 status in breast cancer. World J Surg Oncol. Discordance of the estrogen receptor and HER-2/neu in breast cancer from primary lesion to first and second metastatic site. Lower EE, Khan S, Kennedy D, Baughman RP. Implications of the Updated 2013 American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations on Human Epidermal Growth Factor Receptor 2 Gene Testing Using Immunohistochemistry and Fluorescence In Situ Hybridization for Breast Cancer. Lim TH, Lim AS, Thike AA, Tien SL, Tan PH. Comparison of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) assessment for Her-2 status in breast cancer. Updated UK Recommendations for HER2 assessment in breast cancer. HER2: biology, detection, and clinical implications. ![]()
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