P2, N=702, Recruiting, West German Study Group | Active, not recruiting --> Recruiting | N=402 --> 702 | Trial completion date: Jun 2029 --> Sep 2030 | Trial primary completion date: Jun 2025 --> Jun 2030

Given the clinical severity, inpatient treatment was promptly initiated with trastuzumab and pertuzumab every three weeks, combined with weekly paclitaxel at a 50% dose reduction. In carefully selected patients, early and sustained HER2-directed therapy can lead to meaningful clinical recovery when options appear limited. Such cases help bridge the evidence gap for this high-risk group and may inform future therapeutic considerations.

Patient characteristics reflect current Chinese practice. Increasing adoption of diarrhoea prophylaxis in real-world practice reflects growing clinical experience with neratinib and its recognised benefit in preventing diarrhoea.

In a real-world setting, anthracycline-free neoadjuvant chemotherapy with dual HER2 blockade achieved pCR rates comparable to anthracycline-containing regimens with acceptable toxicity and preserved cardiac safety, suggesting that it may be a reasonable treatment option for selected patients.

Existing studies are generally limited by small sample sizes and a lack of long-term survival data, and high-level evidence directly comparing pyrotinib-based strategies with trastuzumab plus pertuzumab is scarce. Future research should prioritize biomarker-driven patient selection, response-adaptive trial designs, and standardized toxicity management to optimize clinical decision-making.

Prior anti-EGFR therapy and resistance alterations detected by baseline ctDNA profiling are associated with reduced efficacy of PER + TRA in HER2-amplified mCRC. Integrating treatment history with baseline ctDNA profiling might enable improved patient selection for dual HER2-targeted therapy.

P1/2, N=33, Active, not recruiting, H. Lee Moffitt Cancer Center and Research Institute | Recruiting --> Active, not recruiting | Trial completion date: Aug 2026 --> May 2027 | Trial primary completion date: Aug 2026 --> Apr 2027

P2, N=16, Active, not recruiting, Fox Chase Cancer Center | Trial completion date: Dec 2025 --> Dec 2027 | Trial primary completion date: Dec 2025 --> Dec 2026

P1, N=258, Not yet recruiting, Shanghai Henlius Biotech

THPy may provide PFS benefit over THP in HER2+ MBC, with suggestive advantages in patients with de novo stage IV disease and liver metastasis. A higher frequency of diarrhea and other gastrointestinal toxicities was observed in the THPy regimen.

HER2-positive breast cancer is an aggressive subtype effectively targeted by monoclonal antibodies such as trastuzumab and pertuzumab, along with ADCs, TKIs, and chemotherapy...This review highlights emerging therapeutic strategies to address these issues, such as advanced monoclonal antibodies, combination regimens, downstream pathway inhibitors, and cost-effective biosimilars. Emphasis is placed on overcoming resistance mechanisms and improving treatment accessibility, aiming to enhance outcomes for patients with HER2-positive metastatic breast cancer.

Our results show excellent survival outcomes in patients with hormone receptor-positive/HER2-positive eBC who received either a de-escalated chemotherapy or ET in combination with trastuzumab and pertuzumab in the neoadjuvant setting. WSG TP-II confirms the safety and efficacy of a de-escalated and well-tolerated neoadjuvant therapy approach with pCR-guided adjuvant therapy in hormone receptor-positive/HER2-positive eBC.