Utilization, duration, and outcomes of neoadjuvant endocrine therapy in the United States

ConclusionsWomen who received NET had similar rates of BCS compared to women who received NAC. Those who received NET for longer treatment durations had increased odds of BCS and downstaging compared to women who did not receive neoadjuvant therapy.
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research

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Opinion statementNeoadjuvant endocrine therapy (NET) with Ki67-based response monitoring is a practical, cost-effective approach to the management of clinical stage II and III estrogen receptor-positive (ER+) breast cancer. In addition to marked improvements in rates of breast conservation, the identification of extreme responders on the basis of the preoperative endocrine prognostic index (PEPI) provides a rationale to avoid chemotherapy on the basis of highly favorable prognosis in some patients. Finally, samples accrued from patients treated with neoadjuvant therapy are providing valuable insights into the molecular bas...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
NCI's Center for Cancer Research (CCR) Grand Rounds Dr. Matthew Ellis ’ s clinical and basic research focuses on breast cancer. He has developed neoadjuvant endocrine therapy as an alternative to chemotherapy for promoting breast-conserving therapy in postmenopausal women with ER+ HER2- stage 2 and 3 disease. He developed and validated the Ki67 proliferation marker-based Preoperative Endocrine Prognostic Index which is now undergoing a large validation study (the ALTERNATE study). These clinical studies have provided the clinical context and tumor specimens for seminal investigations into the ER+ breast cancer somati...
Source: Videocast - All Events - Category: General Medicine Tags: Upcoming Events Source Type: video
DiscussionThis is the first study to determine the feasibility, efficacy and tolerability of head-to-head neoadjuvant everolimus plus letrozole versus neoadjuvant FEC in treating postmenopausal women with ER-positive, HER2-negative breast cancer. The trial will provide evidence to assess the feasibility of a future multicenter, randomized controlled trial, and will provide valuable clinical data of the immunoregulatory effect of everolimus in breast cancer.Trial registrationClinicalTrials.gov registry, ID:NCT02742051. Registered on 7 April 2016.
Source: Trials - Category: Research Source Type: clinical trials
ConclusionpCR in either the breast or axilla was most likely to be achieved in patients with HER2‐positive or triple‐negative breast cancers. In patients with luminal cancers, the goal of NAST is best considered to facilitate surgical options rather than obtaining a pCR.
Source: ANZ Journal of Surgery - Category: Surgery Authors: Tags: Original Article Source Type: research
Abstract For post-menopausal women with clinical stage II/III estrogen receptor positive (ER+) breast cancer neoadjuvant endocrine therapy (NET) is an under-utilized and low-toxicity alternative to chemotherapy for increasing breast conservation rates. Individual responses to endocrine therapy can also be used to tailor systemic treatment. The Preoperative Endocrine Prognostic Index (PEPI) was developed to identify patients at low risk of relapse after NET so that adjuvant chemotherapy can safely be avoided. In a recent validation study, patients with pathological stage 1 or 2A breast cancers with a Ki67 value of ...
Source: Breast - Category: Cancer & Oncology Authors: Tags: Breast Source Type: research
This article will detail current management approaches to achieving breast conservation in patients with invasive breast cancer, including cases of bulky tumors and/or multiple tumors. PMID: 28516441 [PubMed - in process]
Source: Oncology (Williston Park, N.Y.) - Category: Cancer & Oncology Authors: Tags: Oncology (Williston Park) Source Type: research
BackgroundCurrently, an anthracycline followed by a taxane as adjuvant or neoadjuvant chemotherapy is considered the most effective treatment for patients with triple-negative breast cancer. However, docetaxel followed by an anthracycline as neoadjuvant chemotherapy results in a higher rate of pathological complete response (pCR) than the regimen including an anthracycline followed by docetaxel (Iwata et al. Jpn J Clin Oncol 2011). Adjuvant docetaxel/cyclophosphamide (DC) treatment resulted in prolonged survival compared to adjuvant doxorubicin/cyclophosphamide. Therefore, we planned a phase II trial of DC followed by epir...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Ongoing Clinical Trials Source Type: research
Abstract Primary endocrine therapy is an option in cases of hormone receptor positive and HER2 negative non-metastatic breast cancer. Aromatase inhibitors are considered therapy of choice in postmenopausal patients. In premenopausal patients aromatase inhibitors in combination with LHRH-analogues are regarded superior to tamoxifen. Three different settings have to be discriminated: • Patients too frail for surgery are candidates for primary endocrine therapy in order to control the disease. Treatment duration is determined by the course of the disease. • Patients with tumors not operable in general or no...
Source: Reviews on Recent Clinical Trials - Category: Cancer & Oncology Authors: Tags: Rev Recent Clin Trials Source Type: research
Authors: Matikas A, Foukakis T, Michalakis I, Georgoulias V Abstract INTRODUCTION: Although neoadjuvant chemotherapy has been widely adopted as it increases breast conservation rates, permits the in vivo testing of the activity of chemotherapeutics and offers the opportunity to conduct translational research based on longitudinal assessments of tumor tissue, neoadjuvant endocrine therapy has been met with skepticism owing to slow regression rates and a low chance for pathologic remission. Areas Covered: Herein, the results of clinical trials comparing different endocrine agents as neoadjuvant treatment, endocrine t...
Source: Expert Review of Anticancer Therapy - Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research
Abstract Neoadjuvant systemic therapies have been extensively evaluated in luminal breast cancer. Conventional cytotoxic chemotherapy increases breast conservation rate, albeit with a low level of complete pathological response of uncertain clinical significance. Endocrine therapies allow similar clinical results with much less side effects. Biological criteria of response to endocrine therapies are still being defined. The neoadjuvant setting must be used for early development of new compounds and to further document biological mechanisms of sensitivity and resistance to treatments. PMID: 27817858 [PubMed - ...
Source: Bulletin du Cancer - Category: Cancer & Oncology Authors: Tags: Bull Cancer Source Type: research
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