Sergio Cifuentes Canaval: Exciting insights from the MRI-guided optimization study in HER2+ breast cancer!
Sergio Cifuentes Canaval, Student Fellow at National Autonomous University of Mexico, shared a post on LinkedIn:
“TRAIN 3 Study: Exciting insights from the MRI-guided optimization study in HER2+ breast cancer!
– Background: The MRI-guided optimization study (TRAIN-3) aimed to evaluate neoadjuvant chemotherapy (NAC) duration in stage II-III HER2-positive breast cancer.
– Study Design: Conducted across 43 hospitals in the Netherlands, the single-arm phase 2 trial enrolled patients aged ≥18 years with WHO performance status of 0-1. Patients received paclitaxel, trastuzumab, carboplatin, and pertuzumab intravenously.
– Results:
– Patient Enrollment: 235 HR-negative and 232 HR-positive patients participated.
– Radiological Complete Response:
– HR-negative:
– 36% (1-3 cycles)
– 60% (1-6 cycles)
– 73% (1-9 cycles)
– HR-positive:
– 29% (1-3 cycles)
– 51% (1-6 cycles)
– 59% (1-9 cycles)
– Pathological Complete Response (PCR):
– HR-negative: 87% (1-9 cycles)
– HR-positive: 53% (1-9 cycles)
– Interpretation:
– Early Response Identification: A third of HR-negative patients achieved complete pathological response after just three cycles of NAC.
– Imaging-Based Strategy: MRI-detected complete response could aid in early identification of responders, potentially limiting chemotherapy duration, reducing side effects, and maintaining quality of life.
– My Toughts:
1. Patients completing 4 cycles of Taxanes and Platinum should transition to Anthracycline phase to boost response rates.
2. The benefit of extending Platinum cycles to 9 without advancing to Anthracycline phase remains uncertain.
3. MRI use may pose challenges in our setting but is a valuable strategy for chemotherapy de-escalation.”
I think this a very important generation Hypothesis Study in the optimization of CHT in LABC HER2 +.”
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