Sneha Phadke1. 1. Department of Internal Medicine, Holden Comprehensive Cancer Center, University of Iowa Carver College of Medicine, Iowa City, IA, USA. Sneha-Phadke@uiowa.edu.
Abstract
PURPOSE OF REVIEW: Neoadjuvant, or pre-operative, therapy for the treatment of early-stage breast cancer has several potential benefits, especially for patients with triple-negative or HER2 + subtypes. This review provides an overview of optimal practices for utilizing neoadjuvant therapy, guidelines for decision-making, and ongoing clinical trials that are expected to help refine therapy choices. RECENT FINDINGS: For triple-negative disease, the addition of the checkpoint inhibitor pembrolizumab to chemotherapy has shown remarkable efficacy, increasing response rates and survival. In the HER2 + setting, we are now able to safely avoid use of anthracyclines in most patients and refine adjuvant treatment choices based on response to neoadjuvant therapy. Results from recent clinical studies highlight advancements in systemic therapy and mark steps toward precision medicine, although reliable biomarkers of therapy response are still needed.
PURPOSE OF REVIEW: Neoadjuvant, or pre-operative, therapy for the treatment of early-stage breast cancer has several potential benefits, especially for patients with triple-negative or HER2 + subtypes. This review provides an overview of optimal practices for utilizing neoadjuvant therapy, guidelines for decision-making, and ongoing clinical trials that are expected to help refine therapy choices. RECENT FINDINGS: For triple-negative disease, the addition of the checkpoint inhibitor pembrolizumab to chemotherapy has shown remarkable efficacy, increasing response rates and survival. In the HER2 + setting, we are now able to safely avoid use of anthracyclines in most patients and refine adjuvant treatment choices based on response to neoadjuvant therapy. Results from recent clinical studies highlight advancements in systemic therapy and mark steps toward precision medicine, although reliable biomarkers of therapy response are still needed.
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Authors: Christina Yau; Marie Osdoit; Marieke van der Noordaa; Sonal Shad; Jane Wei; Diane de Croze; Anne-Sophie Hamy; Marick Laé; Fabien Reyal; Gabe S Sonke; Tessa G Steenbruggen; Maartje van Seijen; Jelle Wesseling; Miguel Martín; Maria Del Monte-Millán; Sara López-Tarruella; Judy C Boughey; Matthew P Goetz; Tanya Hoskin; Rebekah Gould; Vicente Valero; Stephen B Edge; Jean E Abraham; John M S Bartlett; Carlos Caldas; Janet Dunn; Helena Earl; Larry Hayward; Louise Hiller; Elena Provenzano; Stephen-John Sammut; Jeremy S Thomas; David Cameron; Ashley Graham; Peter Hall; Lorna Mackintosh; Fang Fan; Andrew K Godwin; Kelsey Schwensen; Priyanka Sharma; Angela M DeMichele; Kimberly Cole; Lajos Pusztai; Mi-Ok Kim; Laura J van 't Veer; Laura J Esserman; W Fraser Symmans Journal: Lancet Oncol Date: 2021-12-11 Impact factor: 54.433