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Preoperative (Neoadjuvant) Systemic Therapy

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Abstract

Neoadjuvant systemic therapy today has become a widely accepted standard therapeutical approach for early breast cancer [13]

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References

  1. Kaufmann M, Goldhirsch A, Hortobagyi GH et al (2006) International expert panel on the use of primary (preoperative) systemic treatment of operable breast cancer: an update. J Clinc Oncol. 23:2600–8

    Google Scholar 

  2. Kaufmann M, von Minckwitz G, Bear HD et al (2007) Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breat cancer: new per spectives 2006. Ann Oncol. 18(2):1927–34

    Article  CAS  PubMed  Google Scholar 

  3. Gralow JR, Burstein HJ, Wood W et al (2008) Preoperative therapy in invasive breast cancer: pathologic assessment and systemic therapy issues in operable disease. J Clinc Oncol. 26:814–9

    Article  Google Scholar 

  4. Fisher B, Brown A, Mamounas E et al (1997) Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from national surgical adjuvant breast and bowel project B-18. J Clin Oncol. 15:2483–3

    CAS  PubMed  Google Scholar 

  5. Fisher B, Bryant J, Wolmark N et al (1998) Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol. 16:2672–85

    CAS  PubMed  Google Scholar 

  6. Wolmark N, Wang J, Mamounas E, et al Preoperative chemotherapy in patients with operable breast cancer: nine-year results from national surgical adjuvant breast and bowel project B-18. J Natl Cancer Inst Monogr. 2001;(30):96–102

    Google Scholar 

  7. van der Hage JA, van de Velde CJ, Julien JP et al (2001) Preoperative chemotherapy in primary operable breast cancer: results from the European organization for research and treatment of cancer trial 10902. J Clin Oncol. 19:4224–37

    PubMed  Google Scholar 

  8. Gianni L, Baselga L, Eiermann W et al (2005) Feasibility and tolerability of sequential doxorubicin/paclitaxel followed by cyclophosphamide/methotrexate and fluorouracil and its effects on tumor response as preoperative chemotherapy. Clin Cancer Res. 11:8715–21

    Article  CAS  PubMed  Google Scholar 

  9. Gianni L, Baselga L, Eiermann W, et al European Cooperative Trial in Operable Breast Cancer (ECTO): improved freedom from progression (FFP) from adding paclitaxel (T) to doxorubicin (A) followed by cyclophosphamide methotrexate and fluorouracil (CMF). Proc Am Soc Clin Oncol. 2005;37a

    Google Scholar 

  10. Bear HD, Anderson S, Smith RE, et al A randomized trial comparing preoperative doxorubicin/cyclophosphamide (AC) to preoperative AC followed by preoperative docetaxel (T) and to preoperative AC followed by postoperative T in patients with operable carcinoma of the breast: results of NSABP B-27. San Antonio Breast Cancer Symposium 2004, San Antonio Texas, December 8–11, 2004

    Google Scholar 

  11. Bear HD, Anderson S, Smith RE et al (2006) Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer: national surgical adjuvant breast and bowel project protokol B-27. J Clin Oncol. 24:2019–27

    Article  CAS  PubMed  Google Scholar 

  12. Mauri D, Pavlidis N, Ioannidis JP (2005) Neoadjuvant versus adjuvant systemic treatment for breast cancer: a meta-analysis. J Natl Cancer Inst. 97:188–94

    Article  PubMed  Google Scholar 

  13. Evans TR, Yellowlees A, Foster E et al (2005) Phase III randomized trial of doxorubicin and docetaxel versus doxorubicin and cyclophosphamide primary medical therapy in women with breast cancer: an anglo-celtic cooperative oncology group study. J Clin Oncol. 23:2988–95

    Article  CAS  PubMed  Google Scholar 

  14. Green MC, Buzdar AU, Smith T et al (2005) Weekly paclitaxel improves pathologic complete remission inoperable breast cancer when comparend with paclitaxel once every three weeks. J Clin Oncol. 23:5983–92

    Article  CAS  PubMed  Google Scholar 

  15. von Minckwitz G, Blohmer JU, Loehr A, et al Comparison of docetaxel/doxorubicin/cyclophosphamide (TAC) versus vinorelbine/capecitabine (NX) in patients non-responding to 2 cycles of neoadjuvant TAC chemotherapy — first results of the phase III GEPARTRIO-Study by the German breast group

    Google Scholar 

  16. Untch M, Möbus V, Kuhn W, et al Intensive dose-dense compared with conventionally scheduled preoperative chemotherapy for high-risk primary breast cancer. J Clin Oncol 2009; Apr 13. San Antonio Breast Cancer Symposium 2005, San Antonio, Texas, December 8–12, 2005

    Google Scholar 

  17. Seidman AD, Bery D, Cirrinicione C et al (2004) CALGB 9840: phase III study of weekly paclitaxel via 1-hour infusion versus standard 3h infusion every third week in treatment of metastatic breast cancer, with trastuzumab for Her2-positive MBC and randomized for T in Her2 normal MBC. Proc Am Soc Clin Oncol. 23:512a

    Google Scholar 

  18. Gralow JR, Burstein HJ, Wood W et al (2008) Preoperative therapy in invasive breat cancer: pathologic assessment and systemic therapy issues in operable disease. J Clin Oncol. 26:814–9

    Article  PubMed  Google Scholar 

  19. Gianni L, Semiglazov V, Manikhas GM, et al Neoadjuvant trastuzumab plus doxorubicin, paclitaxel, and CMF in locally advanced breast cancer (NOAH-trial): Feasibility, safety, and anti-tumor effects. Proc Am Soc Clin Oncol Breast Cancer Symposium. 2007;10s (abstr 532)

    Google Scholar 

  20. Buzdar AU, Ibrahim NK, Francis D et al (2005) Significantly higher pathologic complete remission rate after neoadjuvant therapy with trastuzumab, paclitaxel and epirubicin chemotherapy: results of a randomized trial in human epidermal growth factor receptor 2-positive operable breast cancer. J Clin Oncol. 23:3676–85

    Article  CAS  PubMed  Google Scholar 

  21. von Minckwitz G, Kaufmann M, Kümmel S, et al Integrated meta-analysis on 6402 patients with early breast cancer receiving neoadjuvant anthracycline-taxane +/-trastuzumab containing chemotherapy. San Antonio Breast Cancer Symposium 2008; (abstr 79)

    Google Scholar 

  22. Buzdar AU, Valero V, Ibrahim NK et al (2007) Neoadjuvant therapy with paclitaxel followed by 5-fluororacil, epirubicin, and cyclophosphamide chemotherapy and concurrent trastuzumab in human epidermal growth factor receptor 2-positive operable breast cancer: an update of the initial randomized study population and data of additional patients treated with the same regimen. Clin Cancer Res. 13:228–33

    Article  CAS  PubMed  Google Scholar 

  23. Colleoni M, Viale G, Zahrieh D et al (2008) Expression of ER, PgR, Her1, Her2, and response: a study of preoperative chemotherapy. Ann Oncol. 19:465–72

    Article  CAS  PubMed  Google Scholar 

  24. Cristofanilli M, Gonzalez-Angulo A, Sneige N et al (2005) Invasive lobular carcinoma classic type: response to primary chemotherapy and survival outcomes. J Clin Oncol. 23:41–8

    Article  PubMed  Google Scholar 

  25. Wenzel C, Bartsch R, Hussian D et al (2007) Invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) of breast differ in response following neoadjuvant therapy with epidoxorubicinn and docetaxel+G-CSF. Breast Cancer Res Treat. 104:109–14

    Article  PubMed  Google Scholar 

  26. Arpino G, Bardou VJ, Clark GM et al (2004) Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res. 6:R149–56

    Article  PubMed  Google Scholar 

  27. von Minckwitz G, Raab G, Caputo A et al (2005) Doxorubicin with cyclophosphamide followed by docetaxel every 21 days compared with doxorubicin and docetaxel every 14 days as preoperative treatment in operable breast cancer: the GEPPADUO study of the German breast group. J Clin Oncol. 23:2676–85

    Article  CAS  Google Scholar 

  28. Kaufmann M, Morrow M, von Minckwitz G, R. Harris Loco-regional treatment of primary breast cancer: consensus recommendations from an international expert panel. Cancer. 2009 (in press)

    Google Scholar 

  29. Rouzier R, Pusztail L, Delaloge S et al (2005) Nomograms to predict pathologic complete response and metastasis-free survival after preoperative chemotherapy for breast cancer. J Clin Oncol. 23:8331–9

    Article  PubMed  Google Scholar 

  30. Manton DJ, Chaturvedi A, Hubbard A et al (2006) Neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative MR imaging and spectroscopy. Br J Cancer. 94:427–35

    Article  CAS  PubMed  Google Scholar 

  31. Loibl S, von Minckwitz G, Raab G et al (2006) Surgical procedures after neoadjuvant chemotherapy in operable breast cancer — results of the GEPARDUO trial. Ann Surg Oncol. 13:1434–42

    Article  PubMed  Google Scholar 

  32. McMasters KM, Tuttle TM, Carlson DJ et al (2000) Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multi-institutional practice when optimal technique is used. J Clin Oncol. 18:2560–6

    CAS  PubMed  Google Scholar 

  33. Breslin TM, Cohen L, Sahin A et al (2000) Sentinel lymph node biopsy is accurate after neoadjuvant chemotherapy for breast cancer. J Clin Oncol. 18:3480–6

    CAS  PubMed  Google Scholar 

  34. Julian TB, Patel N, Dusi D et al (2001) Sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer. Am J Surg. 182:407–10

    Article  CAS  PubMed  Google Scholar 

  35. Mamounasa EP, Brown A, Anderson S et al (2005) Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer. Results from national surgical adjuvant breast and bowel project protocol B-27. J Clin Oncol. 23:2694–702

    Article  Google Scholar 

  36. Pockaj BA, Gray RJ (2004) Surgical management of locally advanced breast cancer. J Clin Oncol. 22:85–91

    Google Scholar 

  37. Clarke M, Collins R, Darby S et al (2005) Early breast cancer trialists collaborative group (EBCTCG). Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence, and 15-year survival: an overview of the randomized trials. Lancet. 366:2087–106

    CAS  PubMed  Google Scholar 

  38. Recht A, Edge SB, Solin LJ et al (2001) Postmastectomy radiotherapy: clinical practice guidelines of the American society of clinical oncology. J Clin Oncol. 19:1539–69

    CAS  PubMed  Google Scholar 

  39. Ring A, Webb A, Ashley S et al (2003) Is surgery necessary after complete clinical remission following neoadjuvant chemotherapy for early breast cancer? J Clin Oncol. 21:4540–5

    Article  CAS  PubMed  Google Scholar 

  40. Recht A, Gray R, Davidson NE et al (1999) Locoregional failure 10 years after mastectomy and adjuvant chemotherapy with or without tamoxifen without irradiation: experience of the Eastern cooperative oncology group. J Clin Oncol. 17:1689–700

    CAS  PubMed  Google Scholar 

  41. Semiglazov VF, Semiglazov V, Ivanov V et al (2004) The relative efficacy of neoadjuvant endocrine therapy versus chemotherapy in postmenopausal women with ER-positive breast cancer. J Clin Oncol. 23: 7s

    Google Scholar 

  42. Eiermann W, Paepke S, Apfelstaedt J et al (2001) Preooperative treatment of postmenopausal breast cancer patients with letrozole: a randomized double-blind multicenter study. Ann Oncol. 12:1527–32

    Article  CAS  PubMed  Google Scholar 

  43. Ellis MJ, Coop A, Singh B et al (2001) Letrozole is more effective neoadjuvant endocrine chemotherapy than tamoxifen for erbB-1-and/or erbB-2-positive, estrogen receptor-positive primary breast cancer: evidence from a phase III randomized trial. J Clin Oncol. 19:3808–16

    CAS  PubMed  Google Scholar 

  44. Mustacchi G, Ceccherini R, Milani S et al (2003) Tamoxifen alone versus adjuvant tamoxifen for operable breast cancer of the elderly: long-term results from the phase II randomized controlled multicenter GRETA trial. Ann Oncol. 14:414–20

    Article  CAS  PubMed  Google Scholar 

  45. Goldhirsch A, Ingle JN, Gelber RD, et al (2009) Thresholds for therapies: highlights of the International Consensus on the primary therapy of early breast cancer 2009. Ann Oncol. 20:1319–29

    Article  CAS  PubMed  Google Scholar 

  46. Scholl SM, Fourquet A, Asselain B et al (1994) Neoadjuvant versus adjuvant chemotherapy in premenopausal patients with tumors considered too large for breast conserving surgery: preliminary results of a randomized trial: S6. Eur J Cancer. 30A:645–52

    Article  CAS  PubMed  Google Scholar 

  47. NSABP (2001) The effect on primary tumor response of adding sequential taxotere to adriamycin and cyclophosphamide: preliminary results of the NSABP protocol B-27. Breast Cancer Res Treat. 69:210

    Google Scholar 

  48. Untch M, Konency G, Ditsch N et al (2002) Dose-dense sequential epirubicine-paclitaxel as preoperative treatment of breast cancer: results of a randomized AGO study. Proc Am Soc Clin Oncol. 21:133a

    Google Scholar 

  49. von Minckwitz G, Raab G, Schütte M, et al Dose-dense versus sequential Adriamycin/docetaxel combination as preoperative chemotherapy (pCHT) in operbale breast cancer (T2-3, N0-2, M0): primary endpoint analysis of the GEPARDUO study. Proc Am Soc Clin Oncol. 2003;21:43a (abstr 168)

    Google Scholar 

  50. von Minckwitz G, Blohmer JU, Raab G, et al Comparison of docetaxel/doxorubicin/cyclophosphamide (TAC) versus vinorelbine/capecitabine (NX) in patients non-responding to 2 cycles of neoadjuvant TAC chemotherapy — first results of the phase III GEPARTRIO-study by the German breast group. San Antonio Breast Cancer Symposium 2005

    Google Scholar 

  51. Smith IC, Heys SD, Hutcheon AW et al (2002) Neoadjuvant chemotherapy in breast, cancer: significantly enhanced response with docetaxel. J Clin Oncol. 20:1456–66

    Article  CAS  PubMed  Google Scholar 

  52. Penault-Llorca F, Sastre X, Fiche M et al (1999) Pathological response to neoadjuvant chemotherapy (CT): final results of a prospective randomized trial of 4AT vs. 4AC as induction therapy in patients with operable breast cancer using Sataloff classification. Breast Canc Res Treat. 57:67

    Google Scholar 

  53. Buzdar AU, Singletary SE, Theriault RL et al (1999) Prospective evaluation of paclitaxel versus combination chemotherapy with fluorouracil, doxorubicin and cyclophosphamide as neoadjuvant chemotherapy in patients with operable breast cancer. J Clin Oncol. 17:3412–7

    CAS  PubMed  Google Scholar 

  54. Smith I, Dowsett M, Ebbs SR et al (2005) Neoadjuvant treatment of postmenopausal breast cancer with anastrozole, tamoxifen or both in combination: the immediate preoperative Anastrozole, Tamoxifen or combined with tamoxifen (IMPACT) multicenter double-blind randomized trial. J Clin Oncol. 23:5108–16

    Article  CAS  PubMed  Google Scholar 

  55. Gil Gil A, Barnadas A, Cirera L, et al Primary hormonal therapy with exemestane in patients with breast tumurs >3cm in diameter: results of a Spanish multicenter phase II trial. J Clin Oncol. 2004;23:28s (Suppl; abstr 603)

    Google Scholar 

  56. Paepke S, Tulusan A, Kiesel L et al (2003) A multicenter study of pre-operative treatment with letrozole for optimal duration of treatment in postmenopausal women with ER and/or PgR positive breast cancer. Proc Am Soc Clin Oncol. 22:80

    Google Scholar 

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Correspondence to Manfred Kaufmann .

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Schwedler, K., Kaufmann, M. (2010). Preoperative (Neoadjuvant) Systemic Therapy. In: Jatoi, I., Kaufmann, M. (eds) Management of Breast Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69743-5_22

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  • DOI: https://doi.org/10.1007/978-3-540-69743-5_22

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