Neo-adjuvant therapies for ER positive/HER2 negative breast cancers: from chemotherapy to hormonal therapy, CDK inhibitors, and beyond.

IF 2.9 3区 医学 Q2 ONCOLOGY Expert Review of Anticancer Therapy Pub Date : 2024-03-01 Epub Date: 2024-03-18 DOI:10.1080/14737140.2024.2330601
Athina Stravodimou, Ioannis A Voutsadakis
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Abstract

Introduction: Chemotherapy has been traditionally used as neo-adjuvant therapy in breast cancer for down-staging of locally advanced disease in all sub-types. In the adjuvant setting, genomic assays have shown that a significant proportion of ER positive/HER2 negative patients do not derive benefit from the addition of chemotherapy to adjuvant endocrine therapy. An interest in hormonal treatments as neo-adjuvant therapies in ER positive/HER2 negative cancers has been borne by their documented success in the adjuvant setting. Moreover, cytotoxic chemotherapy is less effective in ER positive/HER2 negative disease compared with other breast cancer subtypes in obtaining pathologic complete responses.

Areas covered: Neo-adjuvant therapies for ER positive/HER2 negative breast cancers and associated biomarkers are reviewed, using a Medline survey. A focus of discussion is the prediction of patients that are unlikely to derive extra benefit from chemotherapy and have the highest probabilities of benefiting from hormonal and other targeted therapies.

Expert opinion: Predictive biomarkers of response to neo-adjuvant chemotherapy and hormonal therapies are instrumental for selecting ER positive/HER2 negative breast cancer patients for each treatment. Chemotherapy remains the standard of care for many of those patients requiring neo-adjuvant treatment, but other neo-adjuvant therapies are increasingly used.

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ER阳性/HER2阴性乳腺癌的新辅助疗法:从化疗到激素疗法、CDK抑制剂及其他疗法。
简介化疗历来被用作乳腺癌的新辅助疗法,用于对所有亚型的局部晚期疾病进行降期治疗。在辅助治疗中,基因组检测显示,相当一部分ER阳性/HER2阴性患者在辅助内分泌治疗的基础上加用化疗并不能获益。ER阳性/HER2阴性癌症患者将激素治疗作为新辅助疗法的兴趣源于其在辅助治疗中的成功记录。此外,与其他乳腺癌亚型相比,细胞毒性化疗在ER阳性/HER2阴性疾病中获得病理完全反应的效果较差:通过 Medline 调查对 ER 阳性/HER2 阴性乳腺癌的新辅助疗法及相关生物标志物进行了综述。讨论的一个重点是预测哪些患者不太可能从化疗中获得额外益处,而从激素和其他靶向疗法中获益的可能性最大:对新辅助化疗和激素疗法反应的预测性生物标志物有助于选择ER阳性/HER2阴性乳腺癌患者接受各种治疗。化疗仍然是许多需要接受新辅助治疗的患者的标准治疗方法,但其他新辅助疗法的使用也越来越多。
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来源期刊
CiteScore
5.10
自引率
3.00%
发文量
100
审稿时长
4-8 weeks
期刊介绍: Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.
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