Personalization of neo/adjuvant treatment of HER2-positive breast cancer is the key to achieve the best results
Abstract
Neoadjuvant therapy of locally advanced breast cancer leads to improved operability, increased rate of breastconserving surgery, the ability to achieve pathologic complete remission, improved prognosis and the ability to monitor tumour response to the treatment. It may also help identify patients who may benefit from trastuzumab emtansine (T-DM1) instead of trastuzumab after surgery.
In addition to standard outcome measures such as relapse rate, disease-free survival and overall survival, which are often used to assess treatment efficacy in adjuvant setting, pathological response, including pathological complete response rate (pCR), is a useful measure of treatment efficacy in patients receiving neoadjuvant therapy. Adjuvant therapy effectively eradicates minimal residual disease, delays potential recurrence, and may save patients' lives.
Underestimation of its indication may harm patients as well as its excessive intensity. An individualized approach with personalization of this indication using the possibility of escalation and de-escalation of treatment can ensure optimal therapeutic outcomes.