Neoadjuvant Paclitaxel, Trastuzumab, and Pertuzumab for Stage II to III, -Positive Breast Cancer

Among patients with stage II to III -positive breast cancer receiving neoadjuvant paclitaxel, trastuzumab, and pertuzumab (THP), what are the long-term outcomes, and can ultrasensitive circulating tumor DNA (ctDNA) monitoring provide a complementary measure of treatment response?In this secondary analysis of the DAPHNe phase 2 nonrandomized clinical trial including 98 patients, the 5-year recurrence-free interval was 98%. Baseline ctDNA was detected in approximately 90% of patients and cleared in 96% after THP; ctDNA was detectable at the time of the single local recurrence and cleared after resection.De-escalated THP produced excellent long-term outcomes, and near-universal ultrasensitive ctDNA clearance after treatment, warranting further validation of ultrasensitive ctDNA as a prognostic tool in this setting.

Corresponding Author: Adrienne G. Waks, MD, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215 (adrienne_waks@dfci.harvard.edu).

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