What neoadjuvant regimen would you give a patient with multicentric IDC consisting of TNBC and concurrent ER/PR- HER2+ breast cancer with ER/PR- HER2+ axillary LN mets?

In cases where we had heterogenous multicentric TNBC and HER2+ disease and the patient had no major cardiac risk factors, we tended to use more AC-THP vs. TCHP in those cases. The addition of the anthracycline to the taxane was felt to be appropriate to better cover both types of cancers (although c...

This question is harder to answer now with the use of TCHP for HER2+ disease and the use of KEYNOTE-522 regimen for TNBC (i.e. would be easier in the AC-TH era). I feel like in this case, I would start with TCHP, and if pCR, feel comfortable to omit the anthracycline for both the TNBC and the HER2+ ...