Is it acceptable to use TCHP instead of AC-T + trastuzumab as neoadjuvant chemotherapy for HER2+ inflammatory breast cancer?

Yes. With the Neosphere trial demonstrating an impressive PCR rate for the TCHP regimen, the TRAIN-2 trial showing no difference in outcomes with anthracycline containing vs non-anthracycline regimen and the BCIRG-006 trial long term follow showing that only 7 DFS events separating AC-TH and TCH, I ...

In general, TCH is approximately equal to ACT. In BCIRG006, the AC-TH arm outperformed TCH by a very small amount from a breast cancer standpoint, approximately offset by slightly higher cardiac toxicity. Both are appropriate; some might use the anthracycline/taxane-based combination to buy as much ...