***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This trial was design ed to compare the efficacy and safety between epirubicin ( E ) and carboplatin ( C ) in combination with paclitaxel ( P ) and trastuzumab ( H ) in neoadjuvant setting . In 13 Chinese cancer centers , 100 patients with HER2-positive , locally advanced breast cancer were 1:1 r and omized to receive medication as follows : trastuzumab and paclitaxel weekly combined with carboplatin weekly for PCH group , or epirubicin every 3 weeks for PEH group . Patients were given 4 to 6 cycles of chemotherapy . The primary endpoint was pathologic complete response ( pCR ) rate , which was no significant difference in PCH and PEH regimen ( 39.1 % vs. 48.8 % ; p=0.365 ) . However , PEH regimen achieved higher pCR in luminal-B ( HER2-poitive ) subgroup ( 55.0 % vs. 24.0 % ; p = 0.033 ) , but not in ERBB2 + subgroup ( 42.9 % vs. 57.1 % ; p = 0.355 ) . PEH regimen showed a favorable efficacy in PIK3CA mutated subgroup ( 69.2 % vs.23.5 % , p=0.012 ) . No significant difference was observed in the subgroup analysis of TP53 mutation status , PTEN expression , FCGR2A SNP and FCGR3A SNP . Both regimens as neoadjuvant chemotherapy achieve similar efficacy and safety .  PEH might improve pCR rate , especially in the luminal-B subtype and PIK3CA mutation subtype . PEH is feasible and less likely to increase the incidence of acute cardiac events compared to PCH BACKGROUND We compared the efficacy and safety of the addition of lapatinib versus trastuzumab to anthracycline-taxane-based neoadjuvant chemotherapy . METHODS In the GeparQuinto r and omised phase 3 trial , patients with untreated HER2-positive operable or locally advanced breast cancer were enrolled between Nov 7 , 2007 , and July 9 , 2010 . Patients were eligible if their tumours were classified as cT3/4a-d , or hormone receptor (HR)-negative , HR-positive with clinical ly node-positive and cT2 disease ( cT2 cN+ ) , or HR-positive and pathologically node-positive in the sentinel lymph node for those with cT1 disease ( cT1 pN(SLN+ ) ) . Patients were r and omly assigned in a 1:1 ratio to receive neoadjuvant treatment with four cycles of EC ( epirubicin [ 90 mg/m(2 ) intravenously ] plus cyclophosphamide [ 600 mg/m(2 ) intravenously ] , every 3 weeks ) , and four cycles of docetaxel ( 100 mg/m(2 ) intravenously every 3 weeks ) with either trastuzumab ( 6 mg/kg intravenously , with a starting loading dose of 8 mg/kg , for eight cycles , every 3 weeks ) or lapatinib ( 1000 - 1250 mg per day orally ) throughout all cycles before surgery . R and omisation was done by dynamic allocation with the minimisation method of Pocock and patients were stratified by participating site , HR status , and extent of disease ( cT1 - 3 cN0 - 2 vs T4 or N3 ) . The primary endpoint was pathological complete response ( defined as ypT0 and ypN0 ) and was analysed in all patients who received at least one cycle of EC . Participants and investigators were not masked to treatment assignment . Pathologists in centres assessing surgery outcomes were masked to group assignment . This trial is registered with Clinical Trials.gov , number NCT00567554 . FINDINGS Of 620 eligible patients , 309 were r and omly assigned to chemotherapy with trastuzumab ( ECH-TH group ) and 311 to chemotherapy with lapatinib ( ECL-TL group ) . Two patients in the ECH-TH group and three patients in the ECL-TL group did not start treatment because of withdrawal of consent or immediate surgery . 93 ( 30·3 % ) of 307 patients in the ECH-TH group and 70 ( 22·7 % ) of 308 patients in the ECL-TL group had a pathological complete response ( odds ratio [ OR ] 0·68 [ 95%CI 0·47 - 0·97 ] ;  p=0·04 )  . Chemotherapy with trastuzumab was associated with more oedema ( 119 [ 39·1 % ] vs 88 [ 28·7 % ] ) and dyspnoea ( 90 [ 29·6 % ] vs 66 [ 21·4 % ] ) , and ECL-TL with more diarrhoea ( 231 [ 75·0 % ] vs 144 [ 47·4 % ] ) and skin rash ( 169 [ 54·9 % ] vs 97 [ 31·9 % ] ) . 43 ( 14·0 % ) patients discontinued in the ECH-TH group and 102 ( 33·1 % ) in the ECL-TL group . 70 serious adverse events were reported in the ECH-TH group and 87 in the ECL-TL group . INTERPRETATION This direct comparison of trastuzumab and lapatinib showed that pathological complete response rate  with chemotherapy and lapatinib was significantly lower than that with chemotherapy and trastuzumab . Unless long-term outcome data show different results , lapatinib should not be used outside of clinical trials as single anti-HER2-treatment in combination with neoadjuvant chemotherapy . FUNDING GlaxoSmithKline , Roche , and Sanofi-Aventis To report the results of the DECT trial , a phase II study of locally advanced or operable HER2‐positive breast cancer ( BC ) treated with taxanes and concurrent anthracyclines and trastuzumab .  Eligible patients ( stage IIA‐IIIB HER2‐positive BC , 18–75 years , normal organ functions , ECOG ≤1 , and left ventricular ejection fraction ( LVEF ) ≥55 % ) received four cycles of neoadjuvant docetaxel , 100 mg/m2 intravenously , plus trastuzumab 6 mg/kg ( loading dose 8 mg/kg ) every 3 weeks , followed by four 3‐weekly cycles of epirubicin 120 mg/m2 and cyclophosphamide , 600 mg/m2 , plus trastuzumab . Primary objective was pathologic complete response ( pCR ) rate , defined as ypT0/is ypN0 at definitive surgery . We enrolled 45 consecutive patients . All but six patients ( 13.3 % ) completed chemotherapy and all underwent surgery . pCR was observed in 28 patients ( 62.2 % ) overall and in 6 ( 66.7 % ) from the inflammatory subgroup . The classification and regression tree analysis showed a 100 % pCR rate in patients with BMI ≥25 and with hormone negative disease . The median follow up was 46 months ( 8–78 ) . Four‐year recurrence‐free survival was 74.7 % ( 95%CI , 58.2–91.2 ) . Seven patients ( 15.6 % ) recurred and one died . Treatment was well tolerated , with limiting toxicity being neutropenia . No clinical cardiotoxicity was observed . Six patients ( 13.4 % ) showed a transient LVEF decrease ( < 10 % ) . In one patient we observed a ≥10 % asymptomatic LVEF decrease persisting after surgery . Notwithst and ing their limited applicability due to the current guidelines , our findings support the efficacy of the regimen of interest in the neoadjuvant setting along with a fairly acceptable toxicity profile , including cardiotoxicity . Results on BMI may invite further assessment in future studies . J. Cell . Physiol . 231 : 2541–2547 , 2016 . © 2016 The Authors . Journal of Cellular Physiology Published by Wiley Periodicals , Objective A previous study demonstrated that non-anthracycline-containing docetaxel plus cyclophosphamide ( TC ) regimen was inferior to docetaxel , anthracycline and cyclophosphamide ( TAC ) in neoadjuvant treatment of triple-negative breast cancer ( TNBC ) and human epidermal growth factor receptor-2-(HER2)-positive breast cancer in a short-term follow-up . Herein , long-term follow-up survival outcomes have been investigated . Methods TNBC or HER2-positive patients were r and omized to receive 6 cycles of TC or TAC neoadjuvant treatment . The primary endpoint was pathological complete remission ( pCR ) . Secondary endpoints included clinical response rate , event-free survival ( EFS ) , and overall survival ( OS ) . Results A cohort of 96 patients consisted of 45 in TC and 51 in TAC arm . With a median follow-up period of 53 ( range , 8–76 ) months , the patients achieving pCR post neoadjuvant chemotherapy exhibited superior EFS and OS than patients without pCR ( P<0.05 ) . TAC treatment result ed in consistently better EFS than TC treatment : the estimated 5-year EFS was 66.1 % vs. 29.8 % ( P=0.002 ) . Moreover , the estimated 5-year OS was also in favor of TAC : 88.4 % vs. 51.6 % ( P<0.001 ) . Multivariable analysis demonstrated that the treatment regimen was an independent prognostic factor , and patients treated with TAC had a superior EFS [ hazard ratio ( HR ) , 0.48 ; 95 % confidence interval ( 95 % CI ) , 0.26–0.90 ; P=0.021 ] and OS ( HR , 0.20 ; 95 % CI , 0.08–0.60 ; P=0.003 ) . Conclusions The up date d long-term follow-up data demonstrated a sustained benefit in EFS and OS from anthracycline-containing TAC treatment , indicating that anthracycline is an essential and effective drug in this clinical trial Purpose Combining anthracyclines and taxanes are to date the most active cytotoxic treatment option in the neoadjuvant and palliative therapy of breast cancer patients . Adding trastuzumab to these cytotoxic agents can improve outcome for women with human epidermal growth factor receptor 2 (HER2)-overexpressing advanced breast cancer . We conducted a pilot study of preoperative epidoxorubicin and docetaxel plus trastuzumab in outpatient patients suffering from breast cancer . Patients and methods Fourteen consecutive patients were enrolled in this prospect i ve clinical pilot trial . Preoperative treatment consisted of weekly trastuzumab ( 4 mg/kg body-weight loading dose , 2 mg/kg/week maintenance dose ) , in combination with weekly epidoxorubicin ( 30 mg/m2 body surface area [ BSA ] ) and docetaxel ( 35 mg/m2 BSA ) once a week for 6 weeks followed by 1 week off therapy . Results Patients received a total of 30 cycles ( median : 2 cycles , range : 2–3 cycles ) of this therapeutic regimen . Outpatient epidoxorubicin and docetaxel plus trastuzumab were well tolerated . A major response to this preoperative therapy regimen could be demonstrated in 12 of 14 patients ( 86 % ) leading to breast-conserving surgery in 11 of 14 patients ( 79 % ) . Conclusions We conclude that outpatient epidoxorubicin and docetaxel plus trastuzumab are safe in the neoadjuvant treatment of patients suffering from breast cancer , based on a favorable side-effect and activity profile . Thus , this regimen can be considered for further clinical trials BACKGROUND The monoclonal antibody trastuzumab has survival benefit when given with chemotherapy to patients with early , operable , and metastatic breast cancer that has HER2 ( also known as ERBB2 ) overexpression or amplification . We aim ed to assess event-free survival in patients with HER2-positive locally advanced or inflammatory breast cancer receiving neoadjuvant chemotherapy with or without 1 year of trastuzumab .  METHODS We compared 1 year of treatment with trastuzumab ( given as neoadjuvant and adjuvant treatment ; n=117 ) with no trastuzumab ( 118 ) , in women with HER2-positive locally advanced or inflammatory breast cancer treated with a neoadjuvant chemotherapy regimen consisting of doxorubicin , paclitaxel , cyclophosphamide , methotrexate , and fluorouracil . R and omisation was done with a computer program and minimisation technique , taking account of geographical area , disease stage , and hormone receptor status . Investigators were informed of treatment allocation . A parallel cohort of 99 patients with HER2-negative disease was included and treated with the same chemotherapy regimen . Primary endpoint was event-free survival . Analysis was by intention to treat . This study is registered , number IS RCT N86043495 . FINDINGS Trastuzumab significantly improved event-free survival in patients with HER2-positive breast cancer ( 3-year event-free survival , 71 % [ 95 % CI 
    Output:
    
In conclusion , the concurrent use of trastuzumab and anthracycline-based NAC for certain HER2-positive locally advanced breast cancers significantly improves the pCR rates without obvious increases in the cardiotoxicity