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The Journal of Clinical Oncology has published secondary results from the ECOG-ACRIN Cancer Research Group's CompassHER2-pCR clinical trial (EA1181, NCT04266249). The findings help identify which early-stage HER2-positive (HER2+) breast cancers may be most likely to respond to less intensive chemotherapy than the current standard.

Patients with early-stage HER2+ breast cancer usually receive multiagent chemotherapy with anti-HER2 drugs before surgery. In CompassHER2-pCR, 2,175 patients with stage II–IIIA disease instead received 12 weeks of a treatment called THP, which combines a single chemotherapy drug (taxane) with two HER2-targeted drugs (trastuzumab and pertuzumab).

Those who had a pathologic complete response (pCR), defined as no invasive cancer in the breast or lymph nodes at surgery, received no additional chemotherapy and continued dual HER2 blockade to complete one year of treatment. The trial is continuing to follow patients with a pCR to assess three-year recurrence-free survival, its primary endpoint.

"Our goal is not simply to give patients less treatment. It is to determine whether we can give each patient the treatment they need to achieve the best possible outcome while avoiding chemotherapy that may not be necessary. The recurrence-free survival results will be critical," said Tung, a medical oncologist at Beth Israel Deaconess Medical Center in Boston.

8% had a pCR. 4% among those with ER-positive (ER+) disease. Characteristics associated with a greater likelihood of pCR included ER-negative or low ER-expressing tumors, low or no progesterone receptor expression, HER2 IHC 3+ tumors and weekly paclitaxel treatment.

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