Early HER2-positive breast cancer: lines of therapy
5 standard-of-care settings across 2 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Stage I, small node-negative tumours | Surgery first, then twelve weeks of paclitaxel with a year of trastuzumab (APT). | 89 | ||
| All comers | Stage II to III, before surgery | Carboplatin, a taxane, trastuzumab and pertuzumab for six cycles without an anthracycline (TRAIN-2), or trastuzumab deruxtecan followed by taxane, trastuzumab and pertuzumab (DESTINY-Breast11). | 97 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Pathological complete response at surgery | Trastuzumab, with pertuzumab in node-positive disease, to complete one year (APHINITY, HERA); endocrine therapy if hormone receptor-positive. | 94 | ||
| All comers | Residual invasive disease at surgery | Trastuzumab deruxtecan (DESTINY-Breast05) or trastuzumab emtansine for fourteen cycles (KATHERINE). | 97 | ||
| All comers | Local therapy and the heart | Breast conservation or mastectomy with sentinel node biopsy, radiotherapy by stage, and echocardiography every three months during trastuzumab. | 68 |
Sequence and caution pairings
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.