A 48-year-old woman with newly diagnosed ER+/HER2- breast cancer (T2N1M0) undergoes neoadjuvant chemotherapy. Residual disease is found at surgery. According to the CREATE-X trial, which agent should now be added to her adjuvant regimen?
- A Olaparib
- B Pertuzumab
- C Capecitabine ✓
- D Abemaciclib
Correct answer: C. Capecitabine
Explanation
The CREATE-X trial demonstrated that adjuvant capecitabine significantly improved disease-free and overall survival in HER2-negative breast cancer patients with residual invasive disease after neoadjuvant chemotherapy. Olaparib is used for BRCA-mutated HER2-negative cancers after chemotherapy but CREATE-X specifically validated capecitabine. Pertuzumab is for HER2+ disease. Abemaciclib (a CDK4/6 inhibitor) is used in high-risk HR+ early breast cancer (MonarchE trial), not as specific post-neoadjuvant residual disease therapy.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.