Impact of biomarkers on pCR and survival after T-DM1 with or without ET vs trastuzumab and ET in HER2/HR positive early BC

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Published: 18 Sep 2021
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Prof Nadia Harbeck - University of Munich, Munich, Germany

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.