ERBB2 and breast carcinoma: We are escalating neoadjuvant therapy by adding a checkpoint inhibitor (pembrolizumab) and dual HER2-directed therapy to neoadjuvant chemotherapy in triple-negative and HER2-positive breast cancer patients even though some studies have shown a de-escalation from the chemo portion of neoadjuvant systemic therapy in selected HER2-positive patients can maintain the high pCR rate, which is translated into an improvement in DFS and OS and a decrease in treatment-associated toxicities [59].