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. disease. The median follow-up was 46 weeks (8C78). Four\yr recurrence\free success was 74.7% (95%CI, 58.2C91.2). Seven individuals (15.6%) recurred and one died. Treatment was well tolerated, with restricting toxicity TNFSF13B becoming neutropenia. No medical cardiotoxicity was noticed. Six individuals (13.4%) showed a transient LVEF lower (<10%). In a single patient we noticed a 10% asymptomatic LVEF lower persisting after medical procedures. Notwithstanding their limited applicability because of the current recommendations, our results support the effectiveness of the routine appealing in the neoadjuvant establishing plus a pretty suitable toxicity profile, including cardiotoxicity. Outcomes on BMI may request further evaluation in potential research. J. Cell. Physiol. 231: 2541C2547, 2016. ? 2016 The Writers. Released by Wiley Periodicals, Inc. Neoadjuvant chemotherapy represents the typical treatment for advanced breasts tumor locally, which is significantly utilized also in individuals with operable disease presently, primarily in unfavourable subsets such as for example triple adverse or human epidermal growth factor\2 (HER2) positive tumors. HER2 is overexpressed or amplified in 15C20% of breast tumors, and confers a more aggressive clinical behaviour. Trastuzumab, a monoclonal antibody targeting the HER2 receptor, used in combination with chemotherapy, significantly improved the prognosis of this unfavourable subset of breast cancer patients, both in advanced and in adjuvant setting (Slamon et al., 2001; Piccart\Gebhart et al., 2005; Romond et al., 2005; Joensuu et al., 2006; Perez et al., 2007; Dawood et al., 2010; Slamon et al., 2011). The role of trastuzumab in combination with chemotherapy has been largely explored in the neoadjuvant setting. Several phase IICIII trials have been conducted, both in locally advanced and in operable HER2\positive breast cancer, with pathological complete response (pCR) rates up to 66% (Buzdar et al., 2005). Yet, the concurrent use of anthracyclines and trastuzumab has been long dismissed due to the high\rate of cardiotoxicity, that is, 27%, reported in the pivotal phase III trial of metastatic breast cancer from Slamon et al. 1180-71-8 (2001). Even if data on cardiotoxicity from the concurrent administration were partly downsized by the results of subsequent trials (Buzdar et al., 2005; Gianni et al., 2010; Untch et al., 2010; Guarneri et al., 2012; Untch et al., 2012; Buzdar et al., 2013), warns against administering these drugs in combinations have remained and current guidelines discourage from the concurrent use of these two drugs in early HER2\positive breast cancer (Denduluri et al., 2016). In 2008, while the discussion on the concomitant administration of these two drugs was still extremely timely to a research agenda, we designed a phase II prospective trial of neoadjuvant chemotherapy with a sequential regimen of trastuzumab (T) and docetaxel (D) followed by trastuzumab and high\dose epirubicin in combination with cyclophosphamide (EC), in patients with HER2\positive operable or locally advanced breast cancer (DECT trial: Docetaxel, Epirubicin, Cyclophosphamide, Trastuzumab). In addition, given the growing interest of our research group towards the role performed by anthropometric determinants in influencing treatment results in breast cancers individuals across different configurations (Vici et al., 2015; D’Aiuto et al., 2016), we relied on data through the DECT trial to help expand check the association between baseline BMI and price of pCR in HER2\positive locally advanced or operable 1180-71-8 breasts cancer and, even more in general, to judge individual\ and disease\related features for his or her effect on treatment results in the environment and population appealing. Strategies and Individuals The DECT trial was conceived as an open up label, stage II potential trial in ladies with recently diagnosed locally advanced or operable, HER2\positive breast cancer. Patients were eligible if diagnosed with a stage IIA to IIIB, histologically proven primary breast cancer. All primary breast cancers had 1180-71-8 undergone a core biopsy prior to neoadjuvant treatment, and staging work\up included complete blood count, chemistry, chest radiography, liver ultrasound or computed tomography scan of the liver and bone scan. Cardiac function evaluation included clinical history, a baseline left ventricular ejection fraction (LVEF) evaluation by echocardiogram, and an electrocardiogram, all repeated after four cycles, at the end of neoadjuvant chemotherapy, and during the follow up period, every 6 months or whenever indicated. All the evaluated patients were 18C75 years old, had normal organ functions, an ECOG performance status (PS) 1, and a baseline left ventricular ejection fraction (LVEF) of 55% or higher measured by echocardiography. Exclusion criteria included pregnancy, metastatic breast cancer, previous chemotherapy, hormonal therapy, radiotherapy, previous other cancers or contralateral breasts cancer, documented background of cardiac disease contraindicating anthracyclines, pre\existent neuropathy or any additional.