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Current Status of Neoadjuvant Endocrine Therapy in Early Stage Breast Cancer

  • Breast Cancer (ML Telli, Section Editor)
  • Published:
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Opinion statement

Neoadjuvant 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 basis for intrinsic resistance to endocrine therapy and promise a more rational basis and precise approach to the systemic treatment of ER+ breast cancer.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Hospital do Câncer Mãe de Deus, Porto Alegre, Brazil

    Tomás Reinert MD

  2. Postgraduation Department of Medical Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

    Tomás Reinert MD

  3. Setor de Mastologia, Hospital das Clínicas, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Rodrigo Gonçalves MD, MSc, PhD

  4. Lester and Sue Smith Breast Cancer Center, Baylor College of Medicine, Houston, TX, 77030, USA

    Matthew J. Ellis MB, BChir, BSc, PhD, FRCP

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  1. Tomás Reinert MD
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Correspondence to Matthew J. Ellis MB, BChir, BSc, PhD, FRCP.

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Conflict of Interest

Tomás Reinert has received research funding from AstraZeneca and has received speaker’s honoraria from AstraZeneca, Novartis, and Pfizer.

Rodrigo Gonçalves declares that he has no conflict of interest.

Matthew J. Ellis has received clinical trial support from Novartis (P024 and Z1031 trials) and Pfizer (Z1031 trial); has received compensation from AstraZeneca, Pfizer, and Novartis for service as a consultant; and has licensed PAM50 patents to NanoString for Prosigna®. The commercial version of PAM50 is not mentioned within this article.

Human and Animal Rights and Informed Consent

Dr Ellis performed the Preoperative Letrozole Study and the Z1031 Study. He was a coinvestigator of the P024 Study. All these studies on human subjects were approved by the relevant ethics committees as outlined in the publications cited.

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This article is part of the Topical Collection on Breast Cancer

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Reinert, T., Gonçalves, R. & Ellis, M.J. Current Status of Neoadjuvant Endocrine Therapy in Early Stage Breast Cancer. Curr. Treat. Options in Oncol. 19, 23 (2018). https://doi.org/10.1007/s11864-018-0538-9

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