Individuals with HER2-positive breast cancer may soon require less chemotherapy before surgery, thanks to a clinical trial currently underway at the Hartford HealthCare Cancer Institute.

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Reducing chemotherapy cycles

For patients with HER2-positive breast cancer, the standard of care is six to eight cycles of chemotherapy before surgery. With the clinical trial, which is open at multiple Hartford HealthCare sites including St. Vincent’s Medical Center in Bridgeport, patients are undergoing only four cycles of treatment prior to surgery.

“This trial for HER2-positive breast cancer is looking at the approach to using chemotherapy before surgery,” said medical oncologist Sara Dost, MD, with St. Vincent’s Medical Center. “We are looking to see if we can give less chemotherapy drugs for a shorter duration of time, compared to the usual approach for HER2-positive breast cancers, without compromising outcomes.”

Not all breast cancer patients qualify

This clinical trial is for those patients who are HER2-positive. HER2 is a protein that helps breast cancer cells grow faster. Breast cancer cells with higher than normal levels of HER2 are called HER2-positive.

“Patients must be clinical stage II, meaning that the cancer is in your lymph nodes under your arm or the tumor is greater than 2 centimeters in size and you have not yet received treatment,” Dr. Dost said.

Patients are then evaluated after surgery. If the cancer in the breast or lymph nodes has completely responded to initial chemotherapy, then the patients may move on to receive further maintenance therapy targeting the HER2 protein. If there is residual cancer at the time of surgery, then the more standard approach of additional chemotherapy may be indicated.

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Early positive outcomes

While the official study data has not yet been released, several patients involved in the trial are doing well after surgery.

“The patients are grateful to have received less chemotherapy,” Dr. Dost said. “Less chemotherapy means fewer side effects.”