Guidelines of Chinese Society of Clinical Oncology (CSCO) on Diagnosis and Treatment of Breast Cancer (2020 version)

Abstract

can be considered during the neoadjuvant treatment in all patients who qualify for single-targeted therapy. 2 The KRISTINE study (1) confirmed the effectiveness and safety of TCbHP regimen in neoadjuvant treatment, Therefore, TCbHP is the preferred regimen in preoperative treatment. 3 The NeoSphere study (2) confirmed that adding pertuzumab to TH could further increase the pCR rate in HER-2-positive patients. However, in the above study, surgery was performed after 4 cycles of neoadjuvant treatment with THP, and the dualtargeted therapy was suspended after surgery and then continued after 3 cycles of FEC therapy. The clinical feasibility of this protocol was quite questionable. 4 The TCbH regimen has been demonstrated to be effective and safe in preoperative neoadjuvant therapy and postoperative adjuvant therapy and thus can be recommended for neoadjuvant therapy (3). 5 Based on the findings of research on ACTH regimen in the single-targeted era, some experts agree that ACTHP can be used as an optional regimen for neoadjuvant therapy, which, however, has not been validated in well-designed clinical studies. 6 According to the GBG69 study (4), albumin paclitaxel has a higher pCR rate than solvent-based paclitaxel in neoadjuvant therapy and it can also improve patients' disease-free survival (DFS). Thus, albumin paclitaxel can also be an optional drug in neoadjuvant therapy.