The standard treatment for patients with HER2-positive breast cancer is based on surgery to remove the tumour. In order to improve the effectiveness of surgery, chemotherapy (consisting of a combination of 3 to 4 drugs), combined with HER2 blockade therapy either before or after surgery, is recommended. With this type of standard treatment, more than 90% of the patients remain alive and free of cancer recurrence after five years [2].
Although these rates are encouraging, there is still room for improvement. Recent studies have shown promising results in patients treated after surgery with HER2 blockade alone and no chemotherapy.
Furthermore, the combination of chemotherapy and HER2 blockade can cause adverse side effects such as hair loss, nausea, vomiting, fatigue, anemia, increased risk of infections, cardiac failure, and leukemia. Most of these side effects can be attributed to chemotherapy, rather than to HER2 blockade.
As an attempt to reduce these side effects, the DECRESCENDO study aims to test a new treatment regimen that relies on the administration of only 1 chemotherapy drug (rather than the conventional 2 to 4 drugs) associated with the HER2 blockade prior to surgery. The goal of this study is to show that this new treatment regimen is as effective as the conventional one, but with less potential to cause side effects.
[2]. Patel A, Unni N and Peng Y. The Changing Paradigm for the Treatment of HER2-Positive Breast Cancer. Cancers (Basel). 2020 Aug; 12(8): 2081.