One Chemo Medicine Before Surgery for Early-Stage HER2-Positive Breast Cancer May Be Better Than Two
People with early-stage HER2-positive breast cancer who receive Abraxane (chemical name: nab-paclitaxel) before surgery may have better outcomes than those who receive Taxotere (chemical name: docetaxel) and carboplatin.
Doctors call treatments given before surgery neoadjuvant treatments.
One way doctors judge the effectiveness of neoadjuvant treatments is to look at the tissue removed during surgery to see if any actively growing cancer cells are present. If no active cancer cells are present, doctors call it a pCR (pathologic complete response).
The study was published in The Lancet Oncology.
Key takeaways
66% of people who received Abraxane had a pCR compared to 58% of people who received Taxotere and carboplatin.
About 30% of people who received Abraxane reported serious (grade 3-4) side effects compared to 38% of people who received Taxotere and carboplatin.
The most common serious side effects among people who received Abraxane were neuropathy, diarrhea, and nausea. Nausea, diarrhea, and vomiting were the most common among people who received Taxotere and carboplatin.
What the results mean for you
In recent years, researchers have started studying de-escalation of cancer treatments. They want to know if the intensity, dose, or number of medicines a person receives could be reduced without affecting how effective the treatment is. They also want to know if treatment de-escalation could cause fewer side effects.
The findings of this study suggest that Abraxane before surgery kills more cancer cells and causes fewer side effects than the standard chemotherapy regimen of Taxotere and carboplatin for early-stage HER2-positive disease.
If more studies confirm these findings, the researchers say Abraxane plus Herceptin and Perjeta before surgery might become a new standard of care for early-stage HER2-positive disease.
About the study
The Chinese study, called HELEN-006, included results from 669 Chinese women diagnosed with stage II or stage III HER2-positive breast cancer between September 2020 and March 2023. The women ranged in age from 43 to 55.
The researchers randomly assigned the women to receive either Abraxane or Taxotere and carboplatin, along with standard anti-HER2 medicines, before surgery:
332 women received Abraxane, Herceptin, and Perjeta
337 women received Taxotere, carboplatin, Herceptin, and Perjeta
Half the women were followed for more than 26 months and half were followed for shorter periods of time.
Detailed results
Women who received Abraxane had a pCR rate of 66.3% and women who received Taxotere and carboplatin had a pCR rate of 57.6% — a difference of about 9 percentage points.
This difference was statistically significant, which means it was likely due to the difference in treatment and not just because of chance.
Women who received Abraxane also had fewer serious side effects:
7% of women who received Abraxane had nausea compared to 23% who received Taxotere and carboplatin
8% of women who received Abraxane had diarrhea compared to 16% of women who received Taxotere and carboplatin
13% of women who received Abraxane had neuropathy compared to 2% of women who received Taxotere and carboplatin.
Chen, Xiu-Chun et al. De-escalated neoadjuvant weekly nab-paclitaxel with trastuzumab and pertuzumab versus docetaxel, carboplatin, trastuzumab, and pertuzumab in patients with HER2-positive early breast cancer (HELEN-006): a multicentre, randomised, phase 3 trial. The Lancet Oncology, Volume 26, Issue 1, 27-36.
Updated on July 3, 2025