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3-year invasive disease-free survival with chemotherapy de-escalation using an 18F-FDG-PET-based, pathological complete response-adapted strategy in HER2-positive early breast cancer (PHERGain): a randomised, open-label, phase 2 trial.

Perez-Garcia JM, Cortes J, Ruiz-Borrego M Colleoni M, Stradella A, Bermejo B et al, on behalf of PHERGain Trial Investigators.

Lancet 2024; 403: 1649-1659.

This complex study that included 356 patients with HER2 +ve breast cancer with visible disease on PET imaging showed that around one third of patients could avoid chemotherapy and just have immunotherapy and hormonal treatment, with similar three-year survival rates.

Comment: Research that reduces the need for chemotherapy is always welcome, and refines the treatment pathway.

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