Would you use paclitaxel and trastuzumab in ER negative, HER2+ breast cancer with micrometastases in a single node?
The NEJM 2015 paper by Tolaney et al only included 1.5% of patients with micrometastases.
Answer from: Medical Oncologist at Academic Institution
Patients with HER2+ disease are doing so well with modern regimens that de-escalation strategies as was done in the APT trial is a goal. However, in that trial virtually all were node-negative (only 6 patients enrolled with micromets) > 90% had tumors no larger 2cm and 2/3 had ER+ disease. So th...