ArticleBreast cancer research and treatment2020
A randomized, 3-arm, neoadjuvant, phase 2 study comparing docetaxel + carboplatin + trastuzumab + pertuzumab (TCbHP), TCbHP followed by trastuzumab emtansine and pertuzumab (T-DM1+P), and T-DM1+P in HER2-positive primary breast cancer.
Article in Breast cancer research and treatment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Systematic review and meta-analysis of febrile neutropenia risk with TCH(P) in HER2-positive breast cancer.Breast cancer research and treatment · 2021Pooled it
- Trial
- Long-term outcomes of neoadjuvant trastuzumab emtansine + pertuzumab (T-DM1 + P) and docetaxel + carboplatin + trastuzumab + pertuzumab (TCbHP) for HER2-positive primary breast cancer: results of the randomized phase 2 JBCRG20 study (Neo-peaks).Breast cancer research and treatment · 2024Trial
- Predicting Pathological Complete Response in Neoadjuvant Dual Blockade With Trastuzumab and Pertuzumab in HER2 Gene Amplified Breast Cancer.Frontiers in immunology · 2022Trial
- Right-sizing treatment for HER2-positive breast cancer: evolving algorithms across the disease continuum.Nature reviews. Clinical oncology · 2026Review
- Bridging Clinical Trials to Real-World Clinical Practice: TCHP Neoadjuvant Therapy Outcomes in HER2-Positive Breast Cancer.Breast cancer (Dove Medical Press) · 2026Article
- Efficacy and safety of pyrotinib combined with trastuzumab and chemotherapy in patients with HER2-positive locally advanced breast cancer: a multicenter real-world study.American journal of translational research · 2026Article
- A Retrospective, Single-Center Study Comparing Neoadjuvant ACTHP vs. DCbHP in HER2-Positive Early Breast Cancer Patients.Cancers · 2025Article
- The optimal neoadjuvant treatment strategy for HR+/HER2 + breast cancer: a network meta-analysis.Scientific reports · 2025Article
- Escalation and optimisation of primary breast cancer treatment with antibody-drug conjugates.Translational breast cancer research : a journal focusing on translational research in breast cancer · 2025Review
- Real-world data on neoadjuvant chemotherapy with dual-anti HER2 therapy in HER2 positive breast cancer.BMC cancer · 2024Article
- Use of Antibody-Drug Conjugates in the Early Setting of Breast Cancer.Clinical Medicine Insights. Oncology · 2024Review
- PR status is a more decisive factor in efficacy of adding pertuzumab into neoadjuvant therapy for HER2-positive and lymph node-positive breast cancer than ER status: a real-world retrospective study in China.World journal of surgical oncology · 2023Article
- Antibody-drug conjugates come of age in oncology.Nature reviews. Drug discovery · 2023Review
- Neoadjuvant therapy withAnnals of translational medicine · 2023Article
- Extracellular Vesicles and Cell Pathways Involved in Cancer Chemoresistance.Life (Basel, Switzerland) · 2022Review
- Neoadjuvant pertuzumab in non-metastatic HER2-positive breast tumors: Multicentric study in Peru (NeoHer).Molecular and clinical oncology · 2022Article
- Review
- Differences between Japan and China in perioperative pharmacotherapy of early-stage breast cancer in breast cancer guidelines (2022 edition).Translational breast cancer research : a journal focusing on translational research in breast cancer · 2022Article
- Efficacy and safety of neoadjuvant therapy for HER2-positive early breast cancer: a network meta-analysis.Therapeutic advances in medical oncology · 2021Article
Corrections and comments
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Authors and funding
19 authors at 12 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe standard of care in the neoadjuvant setting for human epidermal growth factor receptor 2 (HER2)-positive breast cancer is dual HER2-targeted therapy. However, a need to minimize treatment-related toxicity and improve pathological complete response (pCR) rates, particularly in luminal HER2-positive disease, exists.
methodsNeopeaks, a randomized, phase 2 study, compared docetaxel + carboplatin + trastuzumab + pertuzumab (TCbHP; 6 cycles; group A), TCbHP (4 cycles) followed by trastuzumab emtansine + pertuzumab (T-DM1+P; 4 cycles; group B), and T-DM1+P (4 cycles; group C) regimens in HER2-positive primary breast cancer patients; concurrent hormone therapy with T-DM1+P was administered in case of estrogen receptor positivity (ER+). Based on tumor shrinkage, nonresponders in group C were switched to 5-fluorouracil + epirubicin + cyclophosphamide (FEC; 4 cycles). Primary endpoint was pCR (comprehensive pCR ypN0 [ypT0-TisypN0]).
resultsOf 236 patients enrolled, 204 were randomized to groups A (n = 51), B (n = 52), and C (n = 101). In group C, 80 (79%) patients continued T-DM1+P following favorable response, whereas 21 (21%) nonresponders switched to FEC. pCR rate was numerically higher with the TCbHP → T-DM1+P regimen (71%) versus the standard TCbHP (57%) and T-DM1+P (57%) regimens. The rate in group C was higher among responders continuing T-DM1+P (63%) versus nonresponders who switched to FEC (38%). pCR rates after initial 4 cycles of T-DM1+P (group C; 57%) and standard TCbHP regimen (57%) were equivalent. pCR rate in patients with ER+ was significantly higher in group B (69%) than groups A (43%) and C (51%), but was comparable in patients with ER- (67-76%). Compared with the T-DM1-based arm, the incidence of adverse events was higher in the taxane-based arms.
conclusionIn the neoadjuvant setting, the pCR rate with the standard TCbHP → T-DM1+P regimen was numerically better than the TCbHP regimen alone and significantly better in patients with ER+. Personalization of the T-DM1+P regimen could serve as a reasonable approach to minimize toxicity while maintaining efficacy. Trial registration ID: UMIN-CTR: UMIN000014649.
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