Clinical Research Directory

Inclusion Criteria: 1. 18-70 years, 2. ECOG performance status 0-1; 3. Clinical T2-T4, or T1c with axillary lymph node metastasis; Confirmed HER2-positive status (per 2018 ASCO/CAP HER2 Testing Guidelines, defined as IHC 3+ or FISH positive); 4. Clinically measurable lesion: Lesion measurable by ultrasound, mammography, or optional MRI within 1 month before randomization; 5. No chemotherapy contraindications based on organ and bone marrow function tests within 1 month prior to chemotherapy: Absolute neutrophil count (ANC) ≥1.5×10⁹/L, Hemoglobin ≥90 g/L, Platelet count ≥100×10⁹/L, Total bilirubin \<1.5 × ULN (upper limit of normal), Creatinine \<1.5 × ULN, AST/ALT \<1.5 × ULN, Echocardiography: Left ventricular ejection fraction (LVEF) ≥50%; 6. For women of childbearing potential: Negative serum pregnancy test within 14 days before randomization; 7. Signed informed consent form. Exclusion Criteria: 1. Stage IV (metastatic) breast cancer; 2. Prior treatments received including chemotherapy, endocrine therapy, targeted therapy, or radiotherapy; History of other malignancies within 3 years or concurrent malignancies. Exceptions: Other malignancies treated with surgery alone achieving ≥5-year disease-free survival (DFS) . Cured cervical carcinoma in situ or non-melanoma skin cancer; 3. Major non-breast cancer-related surgical procedures within 4 weeks prior to enrollment, or incomplete recovery from such procedures; 4. Significant cardiac disease or conditions including but not limited to: History of heart failure or systolic dysfunction (LVEF \<50%). Uncontrolled high-risk arrhythmias: Atrial tachycardia, resting heart rate \>100 bpm, significant ventricular arrhythmias (e.g., ventricular tachycardia), or high-grade atrioventricular block (Mobitz II second-degree or third-degree AV block). Angina requiring anti-anginal medication. Clinically significant valvular heart disease. ECG evidence of transmural myocardial infarction. Poorly controlled hypertension (SBP \>180 mmHg and/or DBP \>100 mmHg); 5. Contraindications to chemotherapy per investigator's assessment due to severe uncontrolled comorbidities; 6. Known hypersensitivity to protocol drug components; 7. History of immunodeficiency disorders (including HIV positivity), other acquired/congenital immune deficiencies, or organ transplantation; 8. Any concurrent condition that in the investigator's judgment would jeopardize patient safety or compromise study completion, or other grounds for ineligibility.