Dr. Borgen Discusses 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.