A single case report describes a woman with HER2-positive, hormone receptor-positive breast cancer who did not respond well to standard neoadjuvant therapy. After two cycles of trastuzumab and pertuzumab combined with chemotherapy, her tumor showed limited early response. Doctors switched her to a different regimen: trastuzumab plus pyrotinib plus nab-paclitaxel. She then achieved a total pathological complete response, meaning no cancer cells were found in the removed tissue. The patient experienced only mild, controllable diarrhea and tolerated the new regimen well.
This is just one case, so the results cannot be generalized. The report also reviewed existing literature but did not include a controlled trial. The strategy of using early response assessment by chest CT to guide treatment changes needs more study before it can be recommended broadly.
For now, this case offers a possible option for patients who do not respond to initial therapy, but it is not proof that the approach works for everyone. Patients should discuss all treatment options with their oncologist.
