Should neoadjuvant chemotherapy be recommended for HER2+, clinically LN- breast cancer measuring 2-3cm?

If yes, would you still recommend dual HER2 directed therapy?

After the TRYPHAENA trial, neoadjuvant therapy with dual HER2 directed therapy has become the standard approach for HER2+, localized tumor if tumor> 2cm or LN+. The 7 yr update from APT trial (Tolaney et al), reported excellent DFS, OS and RFI for tumors <=3cm. However, that trial only has 36 patients with tumor 2-3cm.

Answer from: Medical Oncologist at Academic Institution

For cT2N0 2-3 cm HER2+ tumors I am still doing neoadjuvant dual blockade chemotherapy for eligible patients in order to assess their pCR status. This guides adjuvant therapy per the KATHERINE study. I usually reserve the APT approach for cT1N0 patients who go to surgery first and are still a stage 1...

Comments

Medical Oncologist at Heartland Cancer Center
In these patients cT2 (2-3 cm) N0, if they achieve...

Medical Oncologist at Los Angeles VA Medical Center
This recent thread addresses whether or not to con...

Answer from: Medical Oncologist at Community Practice

Given excellent results and follow up of APT trial, I prefer paclitaxel and trastuzumab in tumors up to 3 cm. I do not want to give pertuzumab and expose patient to toxicity.

Comments

Medical Oncologist at Mayo Clinic Rochester
While patients with up to 3 cm were eligible for t...

Medical Oncologist at H Lee Moffitt Cancer Center, University of South Florida
I agree with @Amye Tevaarwerk on this. The mi...

Please select the option that best describes you:

Should neoadjuvant chemotherapy be recommended for HER2+, clinically LN- breast cancer measuring 2-3cm?

Related Questions