© 2005 European Society for Medical Oncology
Original article |
Good clinical response of breast cancers to neoadjuvant chemoendocrine therapy is associated with improved overall survival
1 Breakthrough Breast Cancer Research Centre, London; 2 Mount Vernon Hospital, Northwood, Middlesex; 3 Royal Marsden Hospital, Sutton, Surrey; 4 Lincolns Inn Fields Laboratories, London; 5 Parkside Hospital, London, UK
* Correspondence to: Dr S. Cleator, The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, Fulham Road, London SW3 6JB, UK. Tel: +44-20-7970-6058; Fax: +44-20-7878-3858; Email: scleator{at}icr.ac.uk
Background: We present extended follow-up from a prospective randomised trial evaluating the role of neoadjuvant chemoendocrine therapy in the treatment of operable breast cancer.
Patients and methods: 309 women were randomised to primary surgery followed by eight cycles of adjuvant mitoxantrone, methotrexate with tamoxifen (2MT) or 2MT with mitomycin-C (3MT) versus the same regimen for four cycles before followed by four cycles after surgery. For this analysis the median follow-up of patients was 112 months.
Results: After 10 years follow-up there is still no statistically significant difference in disease-free survival (DFS) (71% versus 71%) or overall survival (OS) (63% versus 70%) when comparing adjuvant versus neoadjuvant treatment, respectively. Of 144 evaluable patients in the neoadjuvant arm, 74 achieved a good clinical response and 70 patients achieved a poor clinical response. Good responders had a superior DFS (80% versus 64%, P=0.01) and OS (77% versus 63%, P=0.03) compared to poor responders.
Conclusions: At 10 years, neoadjuvant and adjuvant treatment continue to have equivalent OS and DFS. Good clinical response to neoadjuvant chemotherapy is associated with superior DFS and OS. This supports the use of clinical response of primary breast cancer to neoadjuvant therapy as a surrogate marker of survival benefit.
Key words: breast cancer, chemotherapy, neoadjuvant, response, survival
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. M. Dixon and E. J. Macaskill Neoadjuvant Endocrine Therapy ASCO Educational Book, January 1, 2009; 2009(1): 39 - 43. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-Y. Pierga, F.-C. Bidard, C. Mathiot, E. Brain, S. Delaloge, S. Giachetti, P. de Cremoux, R. Salmon, A. Vincent-Salomon, and M. Marty Circulating Tumor Cell Detection Predicts Early Metastatic Relapse After Neoadjuvant Chemotherapy in Large Operable and Locally Advanced Breast Cancer in a Phase II Randomized Trial Clin. Cancer Res., November 1, 2008; 14(21): 7004 - 7010. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-L. W. Ah-See, A. Makris, N. J. Taylor, M. Harrison, P. I. Richman, R. J. Burcombe, J. J. Stirling, J. A. d'Arcy, D. J. Collins, M. R. Pittam, et al. Early Changes in Functional Dynamic Magnetic Resonance Imaging Predict for Pathologic Response to Neoadjuvant Chemotherapy in Primary Breast Cancer Clin. Cancer Res., October 15, 2008; 14(20): 6580 - 6589. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J S Reis-Filho, C Westbury, and J-Y Pierga The impact of expression profiling on prognostic and predictive testing in breast cancer. J. Clin. Pathol., March 1, 2006; 59(3): 225 - 231. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Bogaerts, R. Sylvester, and P. Therasse Analysis of breast cancer survival by clinical response to neoadjuvant chemoendocrine therapy Ann. Onc., February 1, 2006; 17(2): 352 - 353. [Full Text] [PDF]
|
|