Download PDF
Open Access
CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1815709
Original Article

Assessment of Response to Neoadjuvant Chemotherapy with Single and Dual HER2 Blockade in HER2-Positive Breast Cancers: A Single-Center Experience

Authors

  • Velappan Arumugam 

    1   Department of Medical Oncology, Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India

  • Boopathi Akila 

    1   Department of Medical Oncology, Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India

Funding None.
Further Information
Also available at
  Permissions and Reprints

Abstract

Introduction

Breast cancer remains the leading cause of morbidity and mortality among women and has now become a molecular spectrum rather than a single disease. The human epidermal growth factor receptor 2 (HER2) overexpressing subtype is a rather aggressive form of breast cancer, and its prognosis is improving at a faster pace in recent times with the advent of multiple strategies with targeted agents.

Objectives

In this study, we planned to compare dual and single HER2 blockades—docetaxel, carboplatin, trastuzumab, and pertuzumab (TCHP) and trastuzumab, docetaxel, and carboplatin (TCH)—in the neoadjuvant setting and compare the pathological complete response rates for each protocol, and to assess the toxic effect profile of the regimens.

Materials and Methods

We enrolled 30 patients randomized in a 1:2 fashion to TCHP (n = 9) and TCH (n = 21). The patients' age, tumor staging, and N staging were well matched.

Results

The completion rates of neoadjuvant therapy were 100% in the TCHP arm and 90% in the TCH arm. Breast conservation surgery rates were 22.2 and 5%, respectively, in the TCHP and TCH arms. The pathological complete response rate was 66.7% (6/9; 95% confidence interval [CI]: 29.9–92.5) in the TCHP arm compared with 15.8% (3/19; 95% CI: 3.4–39.6) in the TCH arm, with an absolute difference of 50.9% (95% CI: 12.8–74.5). No grade 3 or higher treatment-related adverse events were observed.

Conclusion

With no added grade 3 adverse events documented in the TCHP arm, we concluded that the addition of pertuzumab would serve as a valuable strategy in the HER2+ subset in the neoadjuvant setting in the population of South Indian origin.

Keywords

NACT - HER2+ - breast cancer - trastuzumab - pertuzumab - dual blockade

Authors' Contributions

V.A. reviewed the manuscript and designed the protocol.


B.A. was responsible for manuscript preparation and data collection.


Patient Consent

Written informed consent was obtained from all the participants.




Publication History

Article published online:
09 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India