Abdel-Razeq H, et al. - Researchers assessed the effectiveness of a treatment regimen for high-risk human epidermal growth factor receptor 2 (HER2)-positive early-stage breast cancer: four cycles of adriamycin and cyclophosphamide [AC] followed by four cycles of docetaxel (NSABP-B27, National Surgical Adjuvant Breast and Bowel Project Protocol B27) with concomitant trastuzumab as neoadjuvant therapy. Apart from being a unique combination, trastuzumab added to the NSABP-B27 regimen in high-risk patients resulted in outcomes similar to reported data. No unexpected toxicities were reported.

• Study included consecutive HER2-positive breast cancer patients treated with this regimen.
• Treatment was given at standard doses and schedules as reported in NSABP-B27.
• They administered trastuzumab with docetaxel and then continued it for 1 year.

• Of 121 patients (mean age 45.4 years) included, the majority exhibited high-risk features including large tumor size, positive axillary lymph nodes, and grade III disease.
• Non-completion of the planned cycles of AC in 3 patients was attributed to a lack of response.
• Data showed that 8 (6.6%) patients missed at least one cycle of docetaxel.
• Surgery was performed on 119 patients following neoadjuvant therapy, of those patients, 59 (49.6%) achieved pathological complete response.
• A higher response was observed in node-negative patients (64.0 vs 45.7%; P=0.03) and in hormone receptor-negative disease patients (69.7 vs 41.9%; P=0.018).
• Also, 21.5% of the patients underwent breast-conserving surgery.
• Researchers noted that the median disease-free survival (DFS) for the whole group was not reached while the 3- and 5-year DFS rates were 84.2 and 74.1%, respectively.