Neoadjuvant Therapy for Her2+
As you likely know, the usual sequence of treatment for early breast cancer is surgery, chemotherapy, then radiation if needed. There are increasing numbers of variations to this routine as care becomes more individualized and different pathologies are better understood. As an aside, over the many years that I have been in the field, there have been a number of trials that looked at different ways to sequence adjuvant therapy. For a while, "sandwich" schedules were common: half the chemo, then radiation, then the other half of chemo. You can well imagine how hard it was for women to return for the second half!
Anyway, neoadjuvant therapy refers to situations in which chemotherapy is given after diagnosis but before surgery. This is often done when a tumor is large, and the hope is to shrink it enough to avoid the necessity of a mastectomy. It may also be done when the cancer is thought to be especially aggressive, so chemo seems more urgent. This is a report from BreastCancer.org about a study reported in Lancet that suggests the best way to manage this for women who have her2 positive breast cancers. This is the beginning and then a link:
Dual HER2 Blockade Better than One as Neoadjuvant Treatment
What breastcancer.org says about this article.
Treatment given to weaken and destroy breast cancer BEFORE surgery is called neoadjuvant treatment. Treatment before surgery isn't routinely used to treat early-stage breast cancer, but may be used if the cancer is large or aggressive. Treatment before surgery is more commonly used for breast cancer that has spread outside the breast to other tissue in the breast area (locally advanced breast cancer). One or more chemotherapy medicines are usually the neoadjuvant treatments used.
Two studies looked at neoadjuvant treatment for HER2-positive breast cancer.
One study, called NeoALTTO, found that giving both Herceptin (chemical name: trastuzumab) and Tykerb (chemical name: lapatinib) with the chemotherapy medicine Taxol (chemical name: paclitaxel) before surgery to treat early-stage or locally advanced HER2-positive breast cancer offered more benefits than giving only Herceptin and Taxol or only Tykerb and Taxol.
The other study, called GeparQuinto, found that Herceptin given with chemotherapy is more effective than Tykerb given with chemotherapy before surgery to treat early-stage or locally advanced HER2-positive breast cancer.