Recht, Abram
Mayo Clinic
Beth Israel Deaconess Medical Center, Boston, MA.
Citations 1
Pathologic Complete Response (pCR) Rate and Predictors of Response to Taxane, Trastuzumab, and Pertuzumab in HER2‑Positive Breast Cancer: Secondary Analyses of EA1181/CompassHER2 pCR
Tung, Nadine , DeMichele, Angela , Winer, Eric P. , Wright, Jean L. , Recht, Abram , Weiss, Anna C., Tjoe, Judy A., Feldman, Sheldon M. , Smith, Mary Lou , O’Sullivan, Ciara C. , Sardesai, Sagar D., Irvin, W. J., Battelli, Chiara, Krie, Amy, D’Abreo, Nina , Shah, Payal D. , DeMichele, Angela , Prat, Aleix , Winer, Eric , Wright, Jean L , Recht, Abram , Rocque, Gabrielle , O'Sullivan, Ciara Catherine , Tang, Shou-Ching , Modi, Shanu , Bagegni, Nusayba , Krie, Amy K , Telli, Melinda L , Borges, Virginia F , D'Abreo, Nina , Shah, Payal D , Villagrasa, Patricia , Badve, Sunil S , Partridge, Ann H , Miller, Kathy D , Carey, Lisa A , Wolff, Antonio C , Tung, Nadine , Zhao, Fengmin , Weiss, Anna , Tjoe, Judy A., Rocque, Gabrielle B. , Sardesai, Sagar , Modi, Shanu , Irvin, William , Unni, Nisha G , George, Mridula Annette , Telli, Melinda L. , Borges, Virginia F. , Badve, Sunil , Partridge, Ann H. , Miller, Kathy D. , Carey, Lisa A. , Wolff, Antonio C.
Journal of Clinical Oncology | August 20, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
PURPOSE EA1181 (ClinicalTrials.gov identifier: NCT04266249 ) is a single-arm trial evaluating neoadjuvant taxane, trastuzumab, and pertuzumab (THP) in patients with clinical stage II/IIIa human epidermal growth factor receptor 2 (HER2)–positive breast cancer. This report focuses on the secondary end points of pathologic complete response (pCR) rates and associated factors. The primary end point—3-year recurrence-free survival among patients achieving a pCR (ypT0/Tis, ypN0)—will be reported when data mature. METHODS Patients received four cycles of trastuzumab and pertuzumab (HP) with either once per week paclitaxel (12 weeks) or docetaxel (every 3 weeks for four cycles), followed by surgery. Clinicopathologic characteristics were assessed in all patients. The HER2DX pCR score was determined using diagnostic biopsy samples in a representative subset. Logistic regression models identified factors associated with pCR. RESULTS A total of 2,175 patients were enrolled (781 HER2+/estrogen receptor‑negative [ER–]; 1,394 HER2+/ER+). Of 2,141 patients who initiated THP, the overall pCR rate was 43.8%: 63.7% in HER2+/ER– and 32.4% in HER2+/ER+ tumors. Higher pCR rates were observed in tumors that were ER-negative or low ER expressing, progesterone receptor-negative or low expressing, HER2 immunohistochemistry (IHC) 3+, and in patients treated with once per week paclitaxel. T3 disease was associated with a lower pCR rate in HER2+/ER– tumors; otherwise, tumor (T) and nodal (N) stage did not significantly affect pCR. Among 569 patients assessed for HER2DX pCR scores, a high score was independently associated with higher pCR rates, after adjustment for clinicopathologic variables. CONCLUSION Neoadjuvant THP achieved pCR in nearly two-thirds of patients with HER2+/ER– and one third with HER2+/ER+ breast cancer. Low hormone receptor expression, HER2 IHC 3+ status, once per week paclitaxel use, and a high HER2DX pCR score were independent predictors of pCR. These findings should help optimize risk stratification and treatment personalization for patients with HER2-positive breast cancer.