ERBB2 and breast carcinoma: The combination of trastuzumab with pyrotinib has demonstrated a similar therapeutic response in patients with HER2-positive breast cancer, with the PHEDRA study reporting a tpCR rate of 41.0%.10 However, despite these promising results, there remains a lack of direct comparative data regarding the efficacy of combining trastuzumab with pertuzumab versus trastuzumab with pyrotinib or other TKIs in the neoadjuvant setting.