Aleix Prat: Insights from SGBCC 2025 on HER2+ early-stage breast cancer treatment decisions
Aleix Prat, Director of the Cancer Institute at the Hospital Clinic of Barcelona, shared a post on LinkedIn:
“Very pleased to see this morning’s voting at the 2025 Early-Stage Breast Cancer St. Gallen International Consensus in Vienna on a clinical case with a HER2+ cT2 (3 cm), cN0, HR-negative disease with HER2DX low-risk and pCR-high.
The results showed that 50% of voters used the test results to guide systemic treatment decisions, and 25% opted for de-escalation: upfront surgery (5%), neoadjuvant TH (5%), and neoadjuvant THP (15%). It remains unclear whether those who selected TCHP would have chosen AC-THP in the absence of the test.
Overall, these findings align with the recent publication of the first results from the decision impact study conducted in Spain across 12 hospitals, involving 34 medical oncologists and 297 patients. The study demonstrated a 48.1% change in treatment decisions based on HER2DX.
The heterogeneity observed among the panel in systemic treatment choices for the various HER2+ cases discussed during the session highlights the need for well-validated prognostic and predictive tests to guide decision-making and reduce uncertainty in stage 1-3 HER2+ breast cancer.”
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