{"entity":{"id":"paper-train-2-lancet-oncol-2018","kind":"paper","name":"TRAIN-2: neoadjuvant chemotherapy with or without anthracyclines alongside dual HER2 blockade","aka":[],"tldr":"Leaving out anthracyclines from neoadjuvant chemotherapy made no difference to how many HER2-positive breast cancers disappeared completely when trastuzumab and pertuzumab were given, so the heart-toxic drugs can be dropped.","summary":"Phase 3 trial of 438 patients with stage II to III HER2-positive breast cancer randomised to nine cycles of carboplatin-paclitaxel with trastuzumab and pertuzumab, with or without three initial cycles of an anthracycline-containing regimen.\n\nPathological complete response was 67 percent with anthracyclines and 68 percent without; three-year event-free survival was similar, while febrile neutropenia and cardiac events were more common with anthracyclines.","asOf":"2026-09-17","links":[{"label":"Lancet Oncol 2018","url":"https://doi.org/10.1016/S1470-2045(18)30570-9"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/30413379/"}],"tags":[],"related":[],"cancers":["her2-positive-early-breast-cancer"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["train-2"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet-oncology"],"dependsOn":[],"notes":[],"journal":"The Lancet Oncology","year":2018,"doi":"10.1016/S1470-2045(18)30570-9","pmid":"30413379","authors":"van Ramshorst MS, van der Voort A, van Werkhoven ED, et al.","paperType":"rct","findings":["Pathological complete response 67 percent with vs 68 percent without anthracyclines.","Three-year event-free survival 92.7 percent vs 93.6 percent."],"whatItMeans":"Anthracycline-free carboplatin-taxane chemotherapy with dual HER2 blockade is a standard neoadjuvant regimen, sparing patients cardiac risk without losing efficacy.","caveats":["Not powered for long-term survival differences.","Both arms used nine cycles of chemotherapy, longer than some current regimens."],"changedPractice":true,"participants":438},"route":"/key-papers/paper-train-2-lancet-oncol-2018/","neighbours":{"cancer":[{"id":"her2-positive-early-breast-cancer","kind":"cancer","name":"Early HER2-positive breast cancer","route":"/cancers/her2-positive-early-breast-cancer/"}],"trial":[{"id":"train-2","kind":"trial","name":"TRAIN-2","route":"/trials/train-2/"}],"journal":[{"id":"lancet-oncology","kind":"journal","name":"The Lancet Oncology","route":"/journals/lancet-oncology/"}]}}