For women with HER2-positive breast cancer, a common treatment regimen involves combining three different types of chemotherapy drugs: trastuzumab, docetaxel, and carboplatin. Together, these therapies are known as TCbH. However, a new study has shown that adding a fourth drug may improve outcomes for these patients.

Pyrotinib is an irreversible second-generation HER2-targeted tyrosine kinase inhibitor (TKI). The researchers hypothesized that adding this drug could improve responses to commonly used chemotherapy treatments. And they were right.

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“In this study, TCbH plus pyrotinib neoadjuvant therapy significantly improved the total (complete response) rate of HER2-positive breast cancer patients for about twice (that of) TCbH with a manageable safety (profile),” the authors write.

Researchers studied 67 HER2-positive breast cancer patients with stage II or III cancers, each one randomly assigned to one of two treatment groups. One group received only TCbH as a neoadjuvant treatment, while the other group received the same treatment with the addition of pyrotinib.

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The main goal of the study was to measure pathologic complete response, which means looking at how many of the patients achieved a status of no evidence of invasive or in situ disease in the breast or armpit by the end of the study. They also assessed toxicity, time after treatment ends that the patient stays disease-free, and the percent of patients who experienced a complete or partial response to treatment.

The total complete response rate in the pyrotinib group was 71.4 percent, compared to 36.7 percent in the TCbH alone group. Every patient in the pyrotinib group who went on to have surgery after their treatment achieved at least a partial response, while only 83.3 percent of the TCbH group achieved a response.

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Of course, every cancer treatment comes with its fair share of unpleasant side effects. The most common side effect of the pyrotinib plus TCbH treatment was diarrhea, with “serious” diarrheal events occurring in 28.6 percent of cases, versus only 10 percent of the TCbH alone group. But for many people with HER2-positive cancer, diarrhea, even a severe case, may be a small price to pay in exchange for the improved chance of a full recovery.

The data were presented at the 2021 American Society of Clinical Oncology (ASCO) annual meeting. Further research is needed, but we’re excited to see this step forward in cancer treatment.

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