Neoadjuvant Systemic Therapy in HER2 positive Breast Cancer

Neoadjuvant chemotherapy may offer benefits to properly selected women such as locally advanced breast cancer, also it enhancing the likelihood of breast conservation. Assessment of response to neoadjuvant chemotherapy provides women with an individualized estimate of prognosis. In meta analysis which conducted by Cortazar et al in 2012 was demonstrated that pathologic complete response achieved by neoadjuvant chemotherapy in HER2 positive breast cancer is a prognostic factor. However there are different regimens for neoadjuvant chemotherapy which HER-2 targeting .By searching in PubMED we found more than 50 trials which used HER-2 blockade.Most of them are single arm phase studies. Trastuzumab, lapatinib and pertuzumab has been used in order to targeting HER-2 receptors. Even there are dual blockade trials and it sounds that it is reasonable to consider dual blockade trastuzumab and pertuzumab in combination with taxane in neoadjuvant setting. In this paper we discuss the result of these trials. Actually it is an introduction to answer this question; considering economical condition and assurance coverage in our country, is it rational to recommend these new regimens specially dual blockade of HER-2