Patrick Borgen, MD, chair, Department of Surgery, director, Breast Center, Maimonides Medical Center, discusses clinical trials in neoadjuvant HER2 breast cancer.
Patrick Borgen, MD, chair, Department of Surgery, director, Breast Center, Maimonides Medical Center, discusses clinical trials in neoadjuvant HER2-positive breast cancer.
Some of the earliest clinical trials had a wait time of 5 to 10 years, which is no longer acceptable for today’s patient, says Borgen. In an effort to avoid this, pathologic complete response is being looked at as a reliable intermediate biomarker for clinical trials.
In 2017, two landmark trials called TRYPHAENA and NeoSphere, looked at patients with a wide range of breast cancer, all of which was HER2-positive, Borgen states. These patients received a variety of systemic agents, and then either single or double targeting with HER2. The double targeting group received trastuzumab (Herceptin) and pertuzumab (Perjeta).
Both TRYPHAENA and NeoSphere demonstrate a high rate of pathologic complete response, with one of the trials in women with estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, HER2-positive breast cancer, the pCR rate exceeded 70%, says Borgen. This supports the position that neoadjuvant treatment for all HER2-positive tumors should be standard, Borgen adds.