Primary Chemotherapy With Anthracycline Followed by Nab-paclitaxel and Trastuzumab

Four cycles of anthracycline-based regimen followed by four cycles of Nab-paclitaxel and Trastuzumab are administrated.

Anthracycline-based regimen (d1, q3w):

EC (Epirubicin 90mg/m2 and Cyclophosphamide 600mg/m2) AC (Doxorubicin 60mg/m2 and Cyclophosphamide 600mg/m2) FEC (Fluorouracil 500mg/m2, Epirubicin 100mg/m2 and Cyclophosphamide 500mg/m2)

Nab-paclitaxel 260mg/m2 (d1, q3w)

Trastuzumab (d1, q3w) is given at a dose of 8 mg/kg IV on day 1 of the first treatment cycle over 90 min, and subsequently given at a dose of 6 mg/kg over 30 min.

Inclusion criteria

• Histologically confirmed invasive breast cancer
• T1c-3 N0-2a
• Confirmed of hormonal receptor status
• HER2 positive confirmed by IHC 3+ or FISH+
• LVEF > 50% by echocardiogram or MUGA
• Adequate EKG
• No prior treatment for breast cancer
• PS 0-1
• Required baseline laboratory data WBC > 4,000/mm3 and Neut > 2,000/mm3 PLT > 100,000/mm3 Hb > 9.0g/dl AST and ALT < ULNx2.5 T-Bil < 1.5mg/dl Serum creatinin < 1.5mg/dl
• Written informed consent

Exclusion criteria

• With history of hypersensitivity reaction for important drug in this study
• With history of invasive breast cancer
• Bilateral invasive breast cancer
• Patients with medical conditions that renders them intolerant to primary chemotherapy and related treatment, including infection, diarrhea, intestinal paralysis, severe Diabetes Mellitus
• Positive for HBs antigen and with history of HVB
• With history of congestive heart failure, uncontrolled or symptomatic angina pectoris, arrhythmia or myocardial infarction, poorly controlled hypertension
• With severe edema
• With severe peripheral neuropathy
• With severe psychiatric disorder
• Pregnant or nursing women
• Cases who physician judged improper to entry this trial