Neoadjuvant Trastuzumab-rezetecan Plus Pertuzumab or Nab-Paclitaxel, Carboplatin, Trastuzumab, and Pyrotinib After Suboptimal Response to Neoadjuvant Dual HER2-Targeted Therapy Combined With Chemotherapy in HER2-Positive Early Breast Cancer

This study is testing a new combination of treatments given before breast cancer surgery (called neoadjuvant therapy) for people with HER2-positive early breast cancer who did not respond well enough to initial standard pre-surgery treatment. It compares two different drug combinations to find the most effective approach. **You may be eligible if...** - You are 18–75 years old - You have HER2-positive early breast cancer (stage I–III) confirmed by biopsy - You have already received standard neoadjuvant HER2-targeted therapy and chemotherapy but did not have a complete response - Your cancer has not spread to distant organs - Your heart and other organ functions are adequate - You are not pregnant **You may NOT be eligible if...** - You received prior cancer treatment for breast cancer before starting neoadjuvant therapy - You have bilateral breast cancer, inflammatory breast cancer, or an unconfirmed diagnosis - Your cancer has spread beyond the breast and nearby lymph nodes Talk to your doctor to see if this trial is right for you.