ArticleTherapeutic advances in medical oncology2026
Tumors >2 cm in node-negative, HER2-positive breast cancer: comparing neoadjuvant dual-targeted versus adjuvant single-targeted treatment pathways in real-world practice.
Article in Therapeutic advances in medical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The optimal systemic treatment for node-negative, human epidermal growth factor receptor 2 (HER2)-positive breast cancer with tumors >2 cm remains unclear. De-escalation is commonly used for smaller tumors, but evidence supporting the neoadjuvant dual-targeted pathway in high tumor burden disease is limited. Objectives: To compare pathological response and exploratory disease-free survival (DFS) between the neoadjuvant dual-targeted and adjuvant single-targeted treatment pathways, focusing on tumors >2 cm. Design: Retrospective, single-center cohort study. Methods: We identified 518 consecutive patients treated from 2015 to 2023 at a tertiary academic center. In a guideline-recommended cohort ( Results: Overlap weighting achieved good balance (all standardized mean differences <0.10). In the guideline-recommended cohort (18 DFS events), the neoadjuvant dual-targeted pathway was not significantly associated with DFS (hazard ratio (HR) 0.26; 95% confidence interval (CI): 0.04-1.55; Conclusion: In this exploratory real-world cohort, the neoadjuvant dual-targeted treatment pathway for node-negative, HER2-positive breast cancer with tumors >2 cm was associated with high pathological response rates and an exploratory DFS signal, though sparse events and observational biases limit survival conclusions. Size-informed, risk-adapted strategies are needed.
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