Credit score: Unsplash/CC0 Public Area
Sufferers with Stage II and III (early-stage) HER2+ breast most cancers often bear preoperative remedy with multi-agent chemotherapy together with anti-HER2 antibodies, adopted by surgical procedure. A much less intensive, diminished chemotherapy remedy method is presently being evaluated within the CompassHER2 pCR trial by the ECOG-ACRIN Most cancers Analysis Group (ECOG-ACRIN).
Whereas longer follow-up is required to evaluate long-term outcomes, pathologic full response (pCR) charges and predictors of pCR are being shared on the 2025 American Society of Medical Oncology (ASCO) Annual Assembly in Chicago, detailing which sufferers could profit most from the brand new method.
“Neoadjuvant treatment with 12 weeks of THP led to a pCR rate of 64% in patients with early-stage HER2-positive, ER-negative breast cancer at the time of surgery, compared to 33% for those with ER-positive tumors,” stated lead investigator Nadine M. Tung, MD, a medical oncologist at Beth Israel Deaconess Medical Middle in Boston. “We also found that among ER-positive breast cancers, lower level of ER expression resulted in higher pCR rates.”
THP combines one chemotherapy drug (a taxane) with the HER2-targeting medicine trastuzumab and pertuzumab. THP is a typical remedy for sufferers with metastatic HER2+ breast most cancers. Earlier small research have proven that sufferers with early-stage illness may also attain a pCR with much less intensive therapies like THP.
CompassHER2 pCR (EA1181) is the primary large-scale trial to guage this method and its final impression on survival. The routine being assessed on this single-arm, non-randomized trial is 12 weeks of preoperative THP (4 cycles of trastuzumab and pertuzumab (HP)) with weekly paclitaxel (12 weeks) or docetaxel (q3w x 4), adopted by surgical procedure.
Regardless of the COVID-19 pandemic, affected person enrollment within the trial was fast, with 2175 members becoming a member of between February 2020 and October 2023. Amongst them, 2141 began THP. Illness development throughout THP occurred in solely 16 sufferers (0.7%).
“If patients achieved a pCR, they did not receive any more chemotherapy, only HER2-directed antibodies after surgery, as well as radiation and endocrine therapy if indicated,” stated Dr. Tung. “Ultimately, this trial should establish if patients who have no residual cancer at surgery after THP can forgo further chemotherapy.”
The first endpoint is 3-year recurrence-free survival, which requires longer follow-up.
The pCR charges introduced at ASCO (Summary 501) are categorized by estrogen receptor (ER) standing and different traits. A subset of 569 sufferers underwent biopsies for evaluation utilizing the HER2DX pCR-score. This laboratory check assigns a low, medium, or excessive rating primarily based on tumor gene expression and medical options.
It’s already identified that amongst HER2+ breast most cancers tumors, these which are ER-negative have a better pCR fee in contrast to people who are ER-positive. This research reveals a number of different predictors of pCR in sufferers with Stage II and III HER2+ breast most cancers. These embody:
ER-negative standing
Decrease ER expression (≤70%) in ER+ tumors
HER2 IHC of three+ (vs. IHC 2+/ISH+)
Use of weekly paclitaxel quite than every-3-week docetaxel
Increased HER2DX pCR rating no matter ER standing
The evaluation didn’t discover an affiliation with the baseline medical stage of illness.
Whereas THP may cause a spread of unintended effects, it’s much less poisonous than regimens that include a number of chemotherapy medicine.
“The findings from this trial may ultimately help clinicians identify which patients with HER2+ breast cancer could be spared from the toxicity of more intensive chemotherapy,” stated Dr. Tung.
Extra info:
Summary 501: conferences.asco.org/abstracts-presentations/243640
Supplied by
ECOG-ACRIN Most cancers Analysis Group
Quotation:
Research: Pre-operative THP results in pCR in 64% of early-stage HER2+ ER- breast most cancers sufferers (2025, June 2)
retrieved 2 June 2025
from https://medicalxpress.com/information/2025-06-pre-thp-pcr-early-stage.html
This doc is topic to copyright. Other than any truthful dealing for the aim of personal research or analysis, no
half could also be reproduced with out the written permission. The content material is offered for info functions solely.
