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Pathologic Complete Response after Neoadjuvant Chemotherapy and Impact on Breast Cancer Recurrence and Survival: A Comprehensive Meta-analysis

Clinical Cancer Research · 2020 · Vol. 26(12) · pp. 2838–2848

Laura M. Spring(Harvard University)Geoffrey Fell(Dana-Farber Cancer Institute)Andrea Arfè(Bocconi University)Chandni Sharma(Massachusetts General Hospital)Rachel A. Greenup(Duke University)Kerry L. Reynolds(Harvard University)Barbara L. Smith(Harvard University)Brian M. Alexander(Harvard University)Beverly Moy(Harvard University)Steven J. Isakoff(Harvard University)Giovanni Parmigiani(Massachusetts Department of Public Health)Lorenzo Trippa(Massachusetts Department of Public Health)Aditya Bardia✉(Harvard University)

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Abstract

Achieving pCR following NAT is associated with significantly better EFS and OS, particularly for triple-negative and HER2<sup>+</sup> breast cancer. The similar outcomes with or without adjuvant chemotherapy in patients who attain pCR likely reflects tumor biology and systemic clearance of micrometastatic disease, highlighting the potential of escalation/deescalation strategies in the adjuvant setting based on neoadjuvant response.<i>See related commentary by Esserman, p. 2771</i>.

Breast Cancer Treatment Studies Breast Lesions and Carcinomas Medical Imaging Techniques and ApplicationsBreast cancerMedicineInternal medicineOncologyChemotherapyNeoadjuvant therapyProportional hazards modelCancerAdjuvantTriple-negative breast cancer

MeSH terms

Antineoplastic Combined Chemotherapy ProtocolsBayes TheoremBreast NeoplasmsHumansNeoplasm Recurrence, LocalChemotherapy, AdjuvantDisease-Free SurvivalNeoadjuvant Therapy