How would you manage a HR+/HER2+ breast cancer patient with no response during neoadjuvant TCHP?

A few thoughts:

1. Although we know that patients with ER+/HER2+ are less likely to respond to neoadjuvant chemo and dual HER2-targeted therapy than those who are ER-/HER2+, I would confirm that the patient is truly HER2+; if the diagnosis was made by IHC, would send FISH or CISH.
2. If the patient has ...