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Strategies emerge for chemotherapy de-escalation in HER2-positive breast cancer

Two studies presented during the ASCO20 Virtual Scientific Program show the potential to de-escalate chemotherapy in the setting of dual HER2 blockade for patients with HER2-positive breast cancer. In the PHERGAIN trial, researchers showed that early evaluation of metabolic response using 18F-FDG PET/CT could help identify patients who will develop a pathologic complete response (pCR) to dual HER2 blockade alone, potentially allowing them to avoid chemotherapy [1].

The PHERGAIN trial, presented by Javier Cortés, MD, PhD, of the Vall d´Hebron Institute of Oncology, in Barcelona, included 356 patients with stage I-IIIA HER2-positive breast cancer. They were randomly assigned 1:4 to receive docetaxel and carboplatin along with trastuzumab and pertuzumab (TCHP; Arm A, 71 patients), or trastuzumab and pertuzumab without chemotherapy but with endocrine therapy in the presence of an estrogen receptor–positive tumor (Arm B, 285 patients). The Figure outlines the s...



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