Early HER2-positive breast cancers: time for a new revolution?
Mené sur 444 patientes atteintes d'un cancer du sein HER2+, cet essai de phase III compare l'efficacité, du point de vue du taux de réponse complète, et la toxicité d'un traitement néoadjuvant à base de trastuzumab emtansine et de pertuzumab et d'un traitement néoadjuvant combinant trastuzumab, pertuzumab et une chimiothérapie (docétaxel et carboplatine)
The first results from trials of trastuzumab in patients with adjuvant HER2-positive breast cancers were rightly stated as revolutionary.1 Because of a striking improvement in the prognosis of this population, anti-HER2 drugs were regarded as the treatment backbone for this disease. The second revolution was to integrate the neoadjuvant setting as a model for the rapid and relevant assessment of new anti-HER2 treatment strategies in HER2-positive breast cancers.2 Therefore, next-generation trials have evolved in two directions addressing different questions: on one hand, the possibility to optimise HER2 blockade and improve outcomes for high-risk populations, and, on the other, the chance to de-escalate chemotherapy and reduce toxicity for low-risk patients.
The Lancet Oncology , commentaire, 2016