Key clinical point: Neoadjuvant chemotherapy with paclitaxel can be safely omitted in patients with human epidermal growth factor receptor 2-positive (HER2+), hormone receptor-negative (HR −) early breast cancer (BC) who achieved pathological complete response (pCR) with only trastuzumab+pertuzumab.
Major finding: The 5-year invasive disease-free survival (iDFS; hazard ratio [HR] 0.32; P = .15) and overall survival (HR 0.41; P = .43) were achieved by a similar proportion early responders in the trastuzumab+pertuzumab without paclitaxel group and all patients in the trastuzumab+pertuzumab+paclitaxel group, irrespective of an early response, with the achievement of pCR being associated with improvement in iDFS (HR 0.14; P = .011).
Study details : Findings are from the phase 2, WSG-ADAPT-HER2+/HR− trial including 134 women with HER2+/HR − early BC who were randomly assigned to receive trastuzumab+pertuzumab with or without weekly paclitaxel for 12 weeks.
Disclosures: This study was funded by Roche and Bayer. Some authors declared serving as codirectors at the West German Study Group or on data safety monitoring boards or advisory boards or receiving research funding, consulting fees, honoraria, or travel support from several sources.
Source: Nitz U et al. De-escalated neoadjuvant pertuzumab plus trastuzumab therapy with or without weekly paclitaxel in HER2-positive, hormone receptor-negative, early breast cancer (WSG-ADAPT-HER2+/HR–): Survival outcomes from a multicentre, open-label, randomised, phase 2 trial. Lancet Oncol. 2022;23(5):625-635 (Apr 8). Doi: 10.1016/S1470-2045(22)00159-0