![]() Trastuzumab emtansine (T-DM1) is an antibody-drug conjugate composed of the humanized monoclonal antibody trastuzumab covalently linked to a cytotoxic agent (i.e., a tubulin inhibitor). ![]() This is of particular relevance for patients with HER2-positive early breast cancer.Ĭhemotherapy (consisting in taxane-based regimens with or without the use of anthracyclines) plus anti-HER2 targeted treatment with trastuzumab and pertuzumab is the current most effective available neoadjuvant therapy in patients with HER2-positive early breast cancer ( 7, 8). However, the neoadjuvant approach has recently gained more attention considering the advantages of both allowing an in vivo assessment of tumor response and increasing the rates of conservative surgery but also because of the possibility to adapt the adjuvant treatment according to the results of the pathology report at the time of surgery ( 6). Administering chemotherapy before surgery is associated with similar survival outcomes as when given in the adjuvant setting ( 5). ![]() Neoadjuvant systemic therapy for breast cancer has been originally conceived to treat patients with locally advanced and/or inoperable disease in order to improve chances and outcomes of surgical resections by downstaging the tumor and regional lymph nodes ( 4). With the introduction of anti-HER2 targeted therapy, the prognosis of patients with HER2-positive breast cancer has radically changed over the last 20 years in both the advanced and early settings ( 3). Human Epidermal Growth Factor Receptor 2 (HER2)-positive disease accounts for approximately 20% of invasive breast neoplasms in the absence of adequate targeted treatment, HER2-positivity leads to a more aggressive behavior and worse clinical outcomes as compared to other subtypes ( 2). Accepted for publication Jan 08, 2020.Īmong women worldwide, breast cancer represents the most frequent malignancy and remains the leading cause of cancer-related death ( 1). Neoadjuvant Trastuzumab Emtansine and Pertuzumab in Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: Three-Year Outcomes From the Phase III KRISTINE Study. The article did not undergo external peer review.Ĭomment on: Hurvitz SA, Martin M, Jung KH, et al. Email: and Peer Review: This article was commissioned by the Editorial Office, Annals of Palliative Medicine. IRCCS Ospedale Policlinico San Martino, University of Genova, Largo Rosanna Benzi 10, 16132 Genova, Italy.
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