Neo-adjuvant treatment of Her2-positive early breast cancer: standard of care and future directions
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Neoadjuvant therapy (NT) is the standard of care for locally advanced (LA) and inflammatory breast cancer (IBC). In Human Epidermal growth Receptor 2 (Her2) overexpressed or amplified breast cancer the addition of the monoclonal antibody Trastuzumab (T) to standard anthracyclines (A) and/or taxanes-based chemotherapy (CT), resulting in improved pathological complete response rate (pCR) compared with CT alone. However, because of T resistance, new targeted drugs with synergistic and/or complementary mechanisms of action, such as Lapatinib and Pertuzumab, were tested alone and in combination with T as neoadjuvant treatment. This review briefly discusses the clinical role of the main anti-Her2 strategies outlining efficacy, safety and tolerability of dual targeting in a neoadjuvant setting.
KEY WORDS: neoadjuvant therapy; early breast cancer; Her2-positive disease; pathological complete response rate.