Assessment of Pathological Response to Neoadjuvant Therapy: Comparison Between Pertuzumab-Based and Non-Pertuzumab Protocols in HER2-Positive Breast Cancer

Keywords:
HER2-Positive Breast Cancer, Pathological Complete Response (pCR), Neoadjuvant Therapy, Pertuzumab, Predictors, Lymphovascular Invasion
Abstract

The importance of neoadjuvant systemic therapy in the treatment of HER2-positive breast cancer has become increasingly evident, particularly in the context of recent advancements in dual HER2 inhibition, which involves the administration of trastuzumab and pertuzumab. A pathological complete response (pCR) after treatment is considered a significant predictor of positive long-term outcomes for this subtype of tumour. The objective of this research is to evaluate the differences in pathological response outcomes between neoadjuvant therapies incorporating pertuzumab and those based solely on trastuzumab for patients diagnosed with HER2-positive breast cancer. A retrospective case-control analysis was performed on 75 individuals diagnosed with HER2-positive breast cancer at a tertiary oncology facility. Participants were divided into two groups: those who underwent therapy including pertuzumab and those who received treatment without it. The clinical, demographic and pathological data were meticulously documented, and pCR was evaluated following definitive surgical intervention. The statistical analyses encompassed chi-square tests and correlation assessments. The average age of participants was 52.5 ± 22.5 years, with a notable prevalence of women who had given birth (88%) and those with a history of breastfeeding (70.6%). Invasive ductal carcinoma constituted the predominant histological type (98.6%). Patients treated with pertuzumab-based neoadjuvant therapy exhibited significantly greater rates of pCR in comparison to those receiving regimens devoid of pertuzumab (80% vs. 48%, p = 0.007). Lymphovascular invasion (LVI) demonstrated a significant correlation with pCR among patients receiving pertuzumab (p = 0.005), while the administration of anthracycline-based regimens within this group indicated the highest probability of achieving a complete pathological response (p = 0.003). Neoadjuvant therapy incorporating pertuzumab has been demonstrated to result in a significant enhancement of pCR rates in patients diagnosed with HER2-positive breast cancer, in comparison with treatments comprising trastuzumab alone. These results support the hypothesis that dual HER2 blockade should be given preferential consideration, particularly in cases where anthracycline-based combinations are an option.Keywords: The following terms are used in this text: HER2-positive breast cancer, pertuzumab, neoadjuvant treatment, dual HER2 inhibition and pathological complete response.

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Published
2026-07-12
Data Availability Statement

The data that supports the findings of this study are available from the corresponding author upon reasonable request.

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Research Article/Original Research
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Copyright (c) 2026 Mais Salah Hassan, Ali Mohammed Jawad

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Hassan, M. S., & Jawad, A. M. (2026). Assessment of Pathological Response to Neoadjuvant Therapy: Comparison Between Pertuzumab-Based and Non-Pertuzumab Protocols in HER2-Positive Breast Cancer. Middle Eastern Cancer and Oncology Journal, 2(3), 1-9. https://doi.org/10.61706/MECOJ160229

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