• Editorial supporting the use of anthracycline-based regimens with the hope of greater efficacy in high-risk HER2-positive BC, with nonanthracycline regimens like TCH an option for lower-risk disease or patients more vulnerable to anthracyclines.

This editorial by an all-star investigator team makes the argument that anthracycline-containing anti-HER2 regimens are being underutilized in community-based practice. As part of this thoughtful review, the respected authors note that only 1 major Phase III adjuvant trial (BCIRG 006) has tested a nonanthracycline regimen (TCH) and the results leave open the possibility of slightly less efficacy. Similarly, they note that although anthracyclines are associated with a small but real risk of cardiac damage and AML/MDS, these complications occur less frequently in younger patients, and therefore the paper concludes that these regimens should be favored in those patients, particularly if they have higher-risk tumors. Interestingly, our previous Patterns of Care surveys reveal that even for younger patients with multiple positive nodes up to half of oncologists in practice and investigators use TCH, suggesting that not everyone sees the data the same way.