Optimal choice of neoadjuvant therapy for HER2-positive breast cancer. Analysis of doctors’ preferences in Russian Federation

Abstract

The development and introduction into widespread practice of anti-HER2 agents has changed the natural course of HER2-positive breast cancer, significantly increasing the chance of cure in early forms and significantly increasing the life expectancy of patients with metastatic disease. The results of clinical trials indicate a significant increase in the frequency of achieving complete pathological regress and improved survival rates when using the combination of trastuzumab + pertuzumab in neoadjuvant therapy for HER2-positive breast cancer, which is reflected in modern national and international guidelines. However, the use of drugs in real clinical practice is associated with a whole range of factors and may differ from standard recommendations. To understand the situation in the Russian Federation, a survey study ‘Therapy of HER2-positive breast cancer’ was conducted. 50 specialists – heads of drug therapy departments and/or their deputies who are directly involved in the development of a treatment plan for patients, were involved in the survey. It allows to reflect the preferences of leading chemotherapists regarding treatment strategies for patients with HER2-positive breast cancer in Russian Federation. This publication highlights the results of a survey on the prescription of neoadjuvant therapy for primary resectable and locally advanced unresectable HER2-positive breast cancer. Most experts prefer to use combinations with pertuzumab. In real clinical practice, 62% of patients receive dual anti-HER2 therapy. In the future, experts are ready to increase the percentage of prescribing pertuzumab for early HER2-positive breast cancer for more 16–20%. Based on the results of large randomized trials, this should improve long-term outcomes in one of the most aggressive forms of breast cancer.