Is a regimen of weekly chemotherapy with trastuzumab and pertuzumab as effective as standard treatment options for HER2-positive breast cancer

This study examined the use of paclitaxel (Taxol) and carboplatin (Paraplatin) as weekly chemotherapy (CT) with trastuzumab (Herceptin) and pertuzumab (Perjeta) in HER2+ breast cancer (BC) in order to reduce toxicity rates. The authors found that the weekly regimen of chemotherapy can be considered an alternative to standard chemotherapy regimens for HER2+ BC. 

BC is one of the most common forms of cancer experienced by women worldwide. HER2 is a protein found on some BC cells that helps tumors grow and spread. HER2+ receptors have been shown to be an effective target for certain anti-cancer drugs such as trastuzumab and pertuzumab.

Standard chemotherapy for BC includes drugs such as paclitaxel and carboplatin. They can be given in combination with trastuzumab and pertuzumab targeted therapies. However,  these chemotherapy drugs can have significant side effects that decrease the quality of life of patients. It is not known if chemotherapy drugs can be given weekly with targeted therapy in order to reduce toxicity in patients with HER2+ BC. 

There were 30 patients with HER2+ BC evaluated in this study. Patients received weekly paclitaxel and carboplatin with trastuzumab and pertuzumab (wPCbTP). After 12-weeks if patients did not respond they were switched to an alternative chemotherapy regimen. This treatment was followed by surgery to remove the tumor. After surgery, almost all patients ()28 out of 30) received radiation therapy to the lymph nodes. Patients were followed up 3 months after surgery.

The complete response rate (no cancer cells left after surgery) was 77%. 3 patients did not respond to the initial chemotherapy and were switched to an alternate option. 2 out of these patients achieved a complete response after surgery. 

The most common side effects after chemotherapy were low white and red blood cell counts and diarrhea. A split dose of pertuzumab was associated with lower rates of diarrhea. 

The authors concluded that weekly chemotherapy with targeted therapy is a good treatment option for patients with HER2+ BC before surgery.

The study size was very small and patients were followed up for a short time. Larger studies are needed.