Dr. Hurvitz on Neoadjuvant Therapy for HER2+ Breast Cancer

Sara Hurvitz, MD, medical oncologist, General Internal Medicine, Hematology and Oncology at UCLA, discusses neoadjuvant treatment options for patients with HER2-positive breast cancer.

Currently in the United States, the FDA has approved 3 neoadjuvant regimens, which are based off of findings from the NeoSphere and TRYPHAENA studies, Hurvitz explains. The NeoSphere study investigated 4 cycles of docetaxel plus trastuzumab and pertuzumab followed by surgery, which had encouraging event-free survival data. After surgery, patients received 3 cycles of FEC—anthracycline-based chemotherapy.

At UCLA, practitioners use TCHP (trastuzumab, carboplatin, docetaxel, and pertuzumab) which has demonstrated pathological complete response (pCR) rates over 50%. Additionally, chemotherapy is not required after surgery, but is given concurrently with HER2-targeted therapies. Following surgery, patients receive single-agent trastuzumab as maintenance therapy, as well as endocrine therapy if their tumor is HR-positive.