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

...atment...

...ommendation from 2022 Guideline Rapid Rec...

...with T1cN1-2 or T2-4N0 (stage II or III), early...


...didates

...juvant chemotherapy is the treatment of...

...histology, grade, stage and estrogen, p...

...uvant systemic therapy should be offered to patien...

...oadjuvant systemic therapy may be offer...

...s for whom a delay in surgery is preferable (e.g....


Measuring Response

...asuring Response...

...receiving neoadjuvant therapy should be monitored...


...ood- and tissue-based biomarkers should not...


...as absence of invasive disease in breas...


Recommended Regimens for Patients with TNBC

...ommended Regimens for Patient...

...atients with TNBC who have clinically node p...


...cT1a or cT1bN0 TNBC should not routinely be offe...


...atin may be offered as part of a neoadjuva...


...re is insufficient evidence to recommen...


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

...ded Neoadjuvant Treatment for Patients with HER2...

...djuvant chemotherapy can be used instead of adj...


...ausal patients with HR+, HER2-negati...


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


Recommended Neoadjuvant Treatment for Patients with HER2-Positive Disease

...ommended Neoadjuvant Treatment for Patients...

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


...h T1a N0 and T1b N0, HER2+ disease should...