Therapeutic options for HER-2 positive breast cancer: Perspectives and future directions

Table 2 Selected clinical trials in the neo-adjuvant setting for human epidermal growth factor receptor-2 positive breast cancer

Study	Neo-adjuvant chemotherapy	No. of patients	Pathological completeresponse (%)	Comments	Ref.
Trastuzumab (H)
MD Anderson Group	T → FEC vs T → FEC + H	19 vs 23	26% (95%CI: 9%-51%) vs 65% (95%CI: 43%-84%)	Probably the first study to emphasize better pCR with H	Buzdar et al[24]
The NOAH Trial	A + T → T → CMF vs A + T → T → CMF + H	117 HER-2 (+) vs 118 HER-2 (+)	22% (95%CI: not reported) vs 43% (95%CI: not reported)	Not originally designed to test the effects of neoadjuvance	Gianni et al[26]
The TECHNO Trial	EC → TH	217	38.7% (95%CI: 32%-45%)	Suggest pCR correlate with DFS	Untch et al[27]
The Z1041 Trial	FEC → TH vs T + H → FEC + H	138 vs 142	56.5% (95%CI: 48%-65%) vs 54.2% (95%CI: 46%-62%)	Concurrent use of H with anthracyclines is not better	Buzdar et al[28]
The HannaH Trial	Doc + H (SQ) → FEC + H vs Doc + H (IV) → FEC + H	260 vs 263	45.4% (95%CI: 39%-52%) vs 40.7% (95%CI: 35%-47%)	H can be administered subcutaneously	Ismael et al[30]
Lapatinib(L) +/- (H)
The GeparQuinto Trial	ECH → TH vs ECL → TL	309 vs 311	30.3% (95%CI: 25%-36%) vs 22.7% (95%CI: 18%-28%)	Lapatinib is less effective that H	Untch et al[31]
The NeoALLTO Trial	TH vs TL vs THL	149 vs 154 vs 152	29.5% (22%–37%) vs 24.7% (22% -37%) vs 51.3% (43%-59%)	Suggested that combination H + L could be quite effective	Baselga et al[32]
The NSABP B-41 Trial	AC → TH or TL or THL	181 vs 174 vs 174	52.5% (50%-59.5%) vs 53.2% (45%-60%) vs 62.0% (54%-69%)	H + L no better. All patients received anthracyclines	Robidoux et al[33]
Pertuzumab (P)
The NeoSphere Trial	Do + H vs Do + P + H vs Do + P vs P + H	107 vs 107 vs 107 vs 96	29.0% (21%-38.5%) vs 45.8% (36%-56%) vs 24.0% (16%-34%) vs 16.8% (10%-25%).	Combination P + H result in better pCR.	Gianni et al[34]
The Tryphaena Trial (Abstract Only)	FEC + HP → Do + HP vs FEC → Do + HP vs TCHP	223 patients in total	62% vs 57% vs 66%	TCH + P is an active combination	N/A

T: Paclitaxel; F: 5-FU; E: Epirubicin; C: Cyclophosphamide; A: Adriamycin; M; Methotrexate; Do: Docetaxel; TC: Docetaxel carboplatin.