Clinical Edge Journal Scan

HR+/ERBB2+ early BC: Excellent pCR rate with de-escalated neoadjuvant paclitaxel plus trastuzumab and pertuzumab


 

Key clinical point: In patients with hormone receptor-positive (HR+) human epidermal growth factor receptor 2-positive (ERBB2+, aka HER2+) breast cancer (BC), de-escalated neoadjuvant chemotherapy with paclitaxel plus trastuzumab and pertuzumab resulted in excellent pathological complete response (pCR) rates, which were superior to those achieved with endocrine therapy plus pertuzumab and trastuzumab.

Major finding: At 12 weeks, endocrine therapy+trastuzumab+pertuzumab led to a significantly inferior pCR rate compared with paclitaxel+trastuzumab+pertuzumab (23.7% vs 56.4%; odds ratio 0.24; P < .001). Both the types of treatment were well tolerated.

Study details: Findings are from the prospective, phase 2 WSG-TP-II trial including 207 patients with HR+/ERBB2+ early BC who were randomly assigned to receive trastuzumab+pertuzumab with paclitaxel or standard endocrine therapy for 12 weeks in the neoadjuvant setting.

Disclosures: This study was supported by Roche Pharma AG. The authors declared receiving personal fees, consulting fees, payments, grants, or travel support or having other ties with Roche and other sources.

Source: Gluz O et al. Efficacy of endocrine therapy plus trastuzumab and pertuzumab vs de-escalated chemotherapy in patients with hormone receptor-positive/ERBB2-positive early breast cancer: The neoadjuvant WSG-TP-II randomized clinical trial. JAMA Oncol. 2023 (May 11). doi: 10.1001/jamaoncol.2023.0646

Recommended Reading

Ribociclib forestalls recurrence also in early breast cancer
MDedge Hematology and Oncology
ER+/HER2– breast cancer: Is first or second line CDK4/6 inhibitor therapy better?
MDedge Hematology and Oncology
Widespread carboplatin, cisplatin shortages: NCCN survey
MDedge Hematology and Oncology
Breast cancer experts and other HCPs disagree on treatment strategies for early BC
MDedge Hematology and Oncology
In TNBC, repeated biopsies may reveal emergent HER2-low expression
MDedge Hematology and Oncology
New study backs up capecitabine dosing practice in metastatic BC
MDedge Hematology and Oncology
Less therapy may suit older patients with breast cancer
MDedge Hematology and Oncology
‘New standard of care’ for capecitabine hand-foot syndrome
MDedge Hematology and Oncology
ACS officer provides ASCO highlights: Targeting hidden cancer, AI in oncology
MDedge Hematology and Oncology
Phase 3 shows promising activity of capivasertib-fulvestrant combo in HR+/HER2− advanced BC
MDedge Hematology and Oncology