Prof Nadia Harbeck speaks to ecancer about the WSG ADAPT TP trial. This trial investigates the predictive impact of biomarkers on pCR and survival after de-escalated neoadjuvant T-DM1 with or without endocrine therapy versus trastuzumab and endocrine therapy in HER2 positive/HR positive early breast cancer.

Initially, she explains the background of the trial. Prof Harbeck then talks about the results. In HER2 positive /HR positive EBC, tumour immunogenicity at baseline is associated with improved survival. Poor outcome associated with PIK3CA mutation cannot be overcome by T-DM1.

Prof Harbeck says that HER2 positive/HR positive tumours are driven by HER2 and ER; this heterogeneous biology needs to be considered for future de-escalation concepts. She concludes by mentioning that beyond pCR, trials in luminal A tumours should focus on survival as an endpoint.