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

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