Neoadjuvant Trastuzumab Concurrent with Nonanthracycline-based Regimens for HER2-positive Locally Advanced Breast Cancer

Trastuzumab, a humanized monoclonal antibody directed against the external domain of the HER-2 protein, has shown remarkable activity against HER-2 positive breast cancer. Consequently, the use of adjuvant trastuzumab plus chemotherapy in patients with HER2-positive stage breast cancer (stage I to III) has become the standard treatment option. However, the role of trastuzumab in neoadjuvant treatment therapy is still uncertain. An increasing number of clinical trials and inadequate analysis show the benefit of adding trastuzumab to chemotherapy in the neoadjuvant setting. We report a case of HER2-positive locally advanced breast cancer in a patient who received cytotoxic agents concomitant with trastuzumab as neoadjuvant therapy, and also review the published literature. The patient achieved pathological complete response, and remained disease-free for more than 5 years.