Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer

Publication Date: April 13, 2022

Key Points

Key Points

  • Multiple studies of both chemotherapy and endocrine therapy have shown that neoadjuvant treatment can increase the likelihood of breast-conserving surgery.
  • The CTNeoBC pooled analysis of neoadjuvant breast cancer clinical trials published in 2014 confirmed that achievement of a pathologic complete response (pCR) with neoadjuvant treatment was prognostic.
    • It also showed that the association between pCR and outcomes was strongest in patients with triple negative and human epidermal growth factor receptor 2 (HER2)-positive disease.
  • Optimal therapy for breast cancer is driven by subtype.

Treatment

...Treatment...

...New Recommendat...

...or patients with T1cN1-2 or T2-4N0 (stag...


...Candidates

...uvant chemotherapy is the treatment of...

...umor histology, grade, stage and estrogen, pro...

...uvant systemic therapy should be of...

Neoadjuvant systemic therapy may be offered to...

...ts for whom a delay in surgery is p...


Measuring Response

...Measur...

...ents receiving neoadjuvant therapy shoul...


...od- and tissue-based biomarkers should not b...


...ned as absence of invasive disease in breast and l...


Recommended Regimens for Patients with TNBC

...Recommended Reg...

...nts with TNBC who have clinically node positive...


...ith cT1a or cT1bN0 TNBC should not routinely...


Carboplatin may be offered as part of a neoadjuvan...


...re is insufficient evidence to recommend...


Recommended Neoadjuvant Treatment for Patients with HER2-negative/HR-positive Breast Cancer

...Recommended Ne...

...oadjuvant chemotherapy can be used...


...al patients with HR+, HER2-negative disease, n...


...remenopausal patients with HR+, HER2-nega...


Recommended Neoadjuvant Treatment for Patients with HER2-Positive Disease

...Recommende...

...with node-positive or high-risk node-neg...


...T1a N0 and T1b N0, HER2+ disease should not be...