For patients with HER2 positive breast cancer s/p neoadjuvant chemotherapy with TC-HP who did not have a complete pathological response at surgery, is there any evidence to use an anthracycline-based chemotherapy after the surgery?

There isn't large comparative data comparing giving anthracyclines vs not in non-PCR patients. In NEOSPHERE all the patients got adjuvant anthracycline after nonanthracycline therapy. It appeared that patients with a PCR did numerically better than non-PCR patients despite all getting anthracyclines. So the adjuvant treatment didn't necessarily salvage everyone who didn't get a PCR. But we don't have a comparator arm with no adjuvant anthracycline therapy.The APHINITY and BIRCG006 trials didn't show major differences between the anthracycline and nonanthracycline arms, but they weren't designed to compare the regimens head to head. I think in a healthier high risk ER- HER2+ patient with rcb2-3 residual disease many would consider giving adj...