Invasive Breast Cancer: HER2-Positive...Preferred Regimens...TCHP (docetaxel/carboplatin/trastuzumab/pertuzumab)

Pathological evaluation of surgical specimens revealed that 55 (52.9%) patients achieved pCR. Menopausal status (p = 0.01), PAM50 intrinsic subtype (p = 0.002), hormone receptor (HR) status (p < 0.001), and HER2 IHC score (p = 0.019) were significantly correlated with the pCR rate....Our findings demonstrate that gene expression patterns can predict the response to neoadjuvant TCHP chemotherapy in HER2+ BC.

In a real-world population of HER2+ eBC patients unfit for anthracyclines, the TCHP regimen demonstrated a higher overall pCR rate compared to a historical control treated with the ACDHP regimen, along with an acceptable cardiac safety profile. These results support the broader use of the TCHP regimen in HER2+ eBC pts...

Pathological evaluation of surgical specimens revealed that 55 (52.9%) patients achieved pCR. Menopausal status (p = 0.01), PAM50 intrinsic subtype (p = 0.002), hormone receptor (HR) status (p < 0.001), and HER2 IHC score (p = 0.019) were significantly correlated with the pCR rate....Our findings demonstrate that gene expression patterns can predict the response to neoadjuvant TCHP chemotherapy in HER2+ BC.

In this single center cohort study, we reviewed patients with stage II-III Her2-positive breast cancer who received a modified chemotherapy regimen of 6 cycles of neoadjuvant paclitaxel (80 mg/m2 days 1 and 8) and reduced dose of carboplatin (AUC= 5 mg/mL/min) with trastuzumab (6 mg/kg; loading dose 8 mg/kg) and pertuzumab (420 mg intravenously; loading dose 840 mg) every 3 weeks from 2021- June 2023....In this single- center retrospective study of patients receiving a modified version of TCHP we found a 60% pCR rate.

Patients included were 18 years of age or older with HER2+ breast cancer and received at least one cycle of neoadjuvant TCHP....Patients who received ≥ 85% RDI had increased pCR rates compared to patients receiving <85% RDI.

Patients received TCbHP (6 cycles, group A), TCbHP followed by T-DM1+P (4 cycles each, group B) or T-DM1+P (4 cycles, group C)....We evaluated 5-yr disease-free survival (DFS), distant DFS (DDFS) and overall survival (OS)....The table shows 5-yr DFS, DDFS and OS rates. Of 181 patients who received A-free neoadjuvant therapy, 116 achieved pCR. Of these, 111 did not receive A after surgery and achieved 5-yr DDFS of 97.3% (91.7%–99.1%) with 3 events....Patients with pCR after neoadjuvant therapy had favorable long-term prognosis...

A total of 159 patients were included in the analysis; pCR was obtained in 66 patients (42%)….The TCHP regimen, which combines chemotherapy and HER2-directed therapy is effective at obtaining pCR in patients with locally advanced HER2+ breast cancer.

We retrospectively reviewed medical records of patients with early or locally advanced HER2-positive BC who underwent neoadjuvant TCHP...The rate of pCR was 64% a class of RCB 0 was observed in 65% of cases, RCB class I in 12%, RCB class II in 14%, and RCB class III in 2%. The three-year event free survival rate was 90.6%, BC with pCR occurred in 92.8%, and BC with non-pCR in 86.3% (p=0.016)....Neoadjuvant TCHP therapy had a pCR rate of 64% and a three-year EFS of 90% in RWE.

This retrospective study aims to evaluate the efficacy and toxicity of neoadjuvant TCH-P regimen in early, locally advanced, and oligometastatic (OM) HER2-positive BC...The clinically ORR and CR were seen in 100% and 60% respectively. Overall pCR rate was observed in 25 (55.6%) patients (70% in stage II)...The TCH-P is an effective, safe, and well-tolerated, protocol with a path CR rate of 55.6%.

We compared efficacy and safety outcomes from 72 Chinese patients with HER2-positive breast cancer who underwent neoadjuvant dual HER2 blockade plus TCb or T chemotherapy and surgery...Univariate analyses revealed that pCR was associated with clinical T classification (P=0.024), AJCC stage (P=0.042), estrogen receptor (ER) status (P=0.002), progesterone receptor (PR) status (P=0.035), Ki-67 index (P<0.001), and immunohistochemical HER2 status (P<0.001)...These results suggest that both TCbHP and THP regimens may be useful neoadjuvant treatments for high-risk early or locally advanced HER2-positive breast cancer.