Rise and Fall of Neoadjuvant Carboplatin for Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer
Mené sur 766 patientes atteintes d'un cancer du sein HER2+, cet essai multicentrique de phase III évalue l'efficacité, du point de vue du taux de réponse complète, et la toxicité d'un traitement néoadjuvant combinant taxane, trastuzumab, pertuzumab avec ou sans carboplatine
Accounting for approximately 20% of all breast cancers, human epidermal growth factor receptor 2–positive (HER2+) tumors were recognized in the 1980s as a particularly aggressive subtype of disease, characterized by high recurrence rates and short survival.1,2 This considerable baseline risk justified a progressive intensification of systemic therapy, in the attempt to increase the rates of cure. Over time, trastuzumab3,4 (H) and pertuzumab5,6 (P) were layered onto an anthracycline-taxane chemotherapy backbone (AC-T + HP); extended therapy with neratinib was implemented for selected patients;7 adjuvant trastuzumab emtansine (T-DM1) became standard for those with residual disease (RD) at surgery8; more recently, adjuvant trastuzumab deruxtecan (T-DXd) emerged as a new highly effective option for patients with RD and high-risk features.9 These escalations transformed long-term outcomes and, over time, radically shifted the therapeutic equation for HER2+ breast cancer. Indeed, the potential toxicities of therapy began to challenge the now lower risks of recurrence, offering an opportunity to safely refine treatment tailoring.
Journal of Clinical Oncology , éditorial, 2026