Assisting Community-Based Oncologists and Surgeons in Making Neoadjuvant Treatment Decisions for Patients with Early Breast CancerNSABP trial B-52: Combining endocrine therapy with anti-HER2 treatment
1:14 minutes.
TRANSCRIPTION:
DR MAMOUNAS: So B-52 builds on the concept that, if you inhibit not only the HER2 pathway in triple-positive breast cancer but also in addition to HER1/HER3 with pertuzumab, if you also inhibit the ER pathway, you may effect higher pathologic complete response rates. As you know, traditionally we don’t give endocrine therapy in the neoadjuvant setting along with chemotherapy. We don’t give it together in the adjuvant setting either, based on the old SWOG trial that saw that if you do it sequentially, you get more antitumor effect than if you give it in combination. However, we believe that some of those data are old data with old chemotherapy regimens and may not be applicable in the HER2-positive setting, particularly when you have total inhibition of the HER2 pathway, or HER1/HER3 pathways, where the ER may be the one that actually causes resistance to an anti-HER therapy. So this is the basic premise of the trial. So it’s a randomized trial in the neoadjuvant setting for triple-positive breast cancer, randomizing to TCHP, neoadjuvant chemotherapy, with or without estrogen deprivation. That can be achieved either with an aromatase inhibitor in postmenopausal or with ovarian ablation and an aromatase inhibitor in the premenopausal setting. |