Skip to main content
Top
Published in: Breast Cancer Research 5/2007

01-10-2007 | Commentary

Clinical trial update: implications and management of residual disease after neoadjuvant therapy for breast cancer

Authors: Erica L Mayer, Lisa A Carey, Harold J Burstein

Published in: Breast Cancer Research | Issue 5/2007

Login to get access

Abstract

Neoadjuvant chemotherapy for breast cancer has a well-established role in the management of patients with locally advanced or early stage disease. Multiple trials have demonstrated superior survival outcomes in individuals achieving a pathologic complete response at the time of definitive surgery, and sophisticated genetic methods may predict which patients will be in this category. Those with less than a pathologic complete response remain at significant risk of recurrent disease, and currently no further standard therapy exists. Ongoing studies of novel agents may lead to improved therapeutic outcomes for this high-risk population.
Appendix
Available only for authorised users
Literature
1.
go back to reference Sachelarie I, Grossbard ML, Chadha M, Feldman S, Ghesani M, Blum RH: Primary systemic therapy of breast cancer. Oncologist. 2006, 11: 574-589. 10.1634/theoncologist.11-6-574.CrossRefPubMed Sachelarie I, Grossbard ML, Chadha M, Feldman S, Ghesani M, Blum RH: Primary systemic therapy of breast cancer. Oncologist. 2006, 11: 574-589. 10.1634/theoncologist.11-6-574.CrossRefPubMed
2.
go back to reference Fisher B, Bryant J, Wolmark N, Mamounas E, Brown A, Fisher ER, Wickerham DL, Begovic M, DeCilis A, Robidoux A, et al: Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol. 1998, 16: 2672-2685.PubMed Fisher B, Bryant J, Wolmark N, Mamounas E, Brown A, Fisher ER, Wickerham DL, Begovic M, DeCilis A, Robidoux A, et al: Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol. 1998, 16: 2672-2685.PubMed
3.
go back to reference Wolmark N, Wang J, Mamounas E, Bryant J, Fisher B: 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, 96-102. Wolmark N, Wang J, Mamounas E, Bryant J, Fisher B: 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, 96-102.
4.
go back to reference van der Hage JA, van de Velde CJ, Julien JP, Tubiana-Hulin M, Vandervelden C, Duchateau L: Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol. 2001, 19: 4224-4237.PubMed van der Hage JA, van de Velde CJ, Julien JP, Tubiana-Hulin M, Vandervelden C, Duchateau L: Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol. 2001, 19: 4224-4237.PubMed
5.
go back to reference Bear HD, Anderson S, Brown A, Smith R, Mamounas EP, Fisher B, Margolese R, Theoret H, Soran A, Wickerham DL, et al: The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide: preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2003, 21: 4165-4174. 10.1200/JCO.2003.12.005.CrossRefPubMed Bear HD, Anderson S, Brown A, Smith R, Mamounas EP, Fisher B, Margolese R, Theoret H, Soran A, Wickerham DL, et al: The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide: preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2003, 21: 4165-4174. 10.1200/JCO.2003.12.005.CrossRefPubMed
6.
go back to reference Bear HD, Anderson S, Smith RE, Geyer CE, Mamounas EP, Fisher B, Brown AM, Robidaux A, Margolese R, Kahlenberg MS, et al: Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer: National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2006, 24: 2019-2027. 10.1200/JCO.2005.04.1665.CrossRefPubMed Bear HD, Anderson S, Smith RE, Geyer CE, Mamounas EP, Fisher B, Brown AM, Robidaux A, Margolese R, Kahlenberg MS, et al: Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer: National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2006, 24: 2019-2027. 10.1200/JCO.2005.04.1665.CrossRefPubMed
7.
go back to reference Mazouni C, Kau SW, Frye D, Andre F, Kuerer HM, Buchholz TA, Symmans WF, Anderson k, Hess KR, Gonzalez-Angulo AM, et al: Inclusion of taxanes, particularly weekly paclitaxel, in preoperative chemotherapy improves pathologic complete response rate in estrogen receptor-positive breast cancers. Ann Oncol. 2007, 18: 874-880. 10.1093/annonc/mdm008.CrossRefPubMed Mazouni C, Kau SW, Frye D, Andre F, Kuerer HM, Buchholz TA, Symmans WF, Anderson k, Hess KR, Gonzalez-Angulo AM, et al: Inclusion of taxanes, particularly weekly paclitaxel, in preoperative chemotherapy improves pathologic complete response rate in estrogen receptor-positive breast cancers. Ann Oncol. 2007, 18: 874-880. 10.1093/annonc/mdm008.CrossRefPubMed
8.
go back to reference Rouzier R, Pusztai L, Delone S, Gonzalez-Angulo AM, Andre F, Hess KR, Buzdar AU, Garbay JR, Spielmann M, Mathieu MC, et al: Nomograms to predict pathologic complete response and metastasis-free survival after preoperative chemotherapy for breast cancer. J Clin Oncol. 2005, 23: 8331-8339. 10.1200/JCO.2005.01.2898.CrossRefPubMed Rouzier R, Pusztai L, Delone S, Gonzalez-Angulo AM, Andre F, Hess KR, Buzdar AU, Garbay JR, Spielmann M, Mathieu MC, et al: Nomograms to predict pathologic complete response and metastasis-free survival after preoperative chemotherapy for breast cancer. J Clin Oncol. 2005, 23: 8331-8339. 10.1200/JCO.2005.01.2898.CrossRefPubMed
9.
go back to reference Gianni L, Zambetti M, Clark K, Baker J, Cronin M, Wu J, Mariani G, Rodriguez J, Carcangiu M, Watson D, et al: Gene expression profiles in paraffin-embedded core biopsy tissue predict response to chemotherapy in women with locally advanced breast cancer. J Clin Oncol. 2005, 23: 7265-7277. 10.1200/JCO.2005.02.0818.CrossRefPubMed Gianni L, Zambetti M, Clark K, Baker J, Cronin M, Wu J, Mariani G, Rodriguez J, Carcangiu M, Watson D, et al: Gene expression profiles in paraffin-embedded core biopsy tissue predict response to chemotherapy in women with locally advanced breast cancer. J Clin Oncol. 2005, 23: 7265-7277. 10.1200/JCO.2005.02.0818.CrossRefPubMed
10.
go back to reference Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, Pollack JR, Ross DT, Johnsen H, Akslen LA, et al: Molecular portraits of human breast tumours. Nature. 2000, 406: 747-752. 10.1038/35021093.CrossRefPubMed Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, Pollack JR, Ross DT, Johnsen H, Akslen LA, et al: Molecular portraits of human breast tumours. Nature. 2000, 406: 747-752. 10.1038/35021093.CrossRefPubMed
11.
go back to reference Sorlie T, Perou CM, Tibshirani R, Aas T, Geistler S, Johnsen H, Hastie T, Eisen MB, van de Rijn M, Jeffrey SS, et al: Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA. 2001, 98: 10869-10874. 10.1073/pnas.191367098.CrossRefPubMedPubMedCentral Sorlie T, Perou CM, Tibshirani R, Aas T, Geistler S, Johnsen H, Hastie T, Eisen MB, van de Rijn M, Jeffrey SS, et al: Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA. 2001, 98: 10869-10874. 10.1073/pnas.191367098.CrossRefPubMedPubMedCentral
12.
go back to reference Sorlie T, Tibshirani R, Parker J, Hastie T, Marron JS, Nobel A, Deng S, Johnsen H, Peisch R, Geisler S, et al: Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci USA. 2003, 100: 8418-8423. 10.1073/pnas.0932692100.CrossRefPubMedPubMedCentral Sorlie T, Tibshirani R, Parker J, Hastie T, Marron JS, Nobel A, Deng S, Johnsen H, Peisch R, Geisler S, et al: Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci USA. 2003, 100: 8418-8423. 10.1073/pnas.0932692100.CrossRefPubMedPubMedCentral
13.
go back to reference Rouzier R, Perou CM, Symmans WF, Ibrahim N, Cristofanelli M, Anderson K, Hess KR, Stec J, Ayers M, Wagner P, et al: Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res. 2005, 11: 5678-5685. 10.1158/1078-0432.CCR-04-2421.CrossRefPubMed Rouzier R, Perou CM, Symmans WF, Ibrahim N, Cristofanelli M, Anderson K, Hess KR, Stec J, Ayers M, Wagner P, et al: Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res. 2005, 11: 5678-5685. 10.1158/1078-0432.CCR-04-2421.CrossRefPubMed
14.
go back to reference Carey LA, Dees EC, Sawyer L, Gatti L, Moore DT, Collichio F, Ollila DW, Sartor CI, Graham ML, Perou CM: The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res. 2007, 13: 2329-2334. 10.1158/1078-0432.CCR-06-1109.CrossRefPubMed Carey LA, Dees EC, Sawyer L, Gatti L, Moore DT, Collichio F, Ollila DW, Sartor CI, Graham ML, Perou CM: The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res. 2007, 13: 2329-2334. 10.1158/1078-0432.CCR-06-1109.CrossRefPubMed
15.
go back to reference Symmans W, Peintinger F, Hatzis C, Kuere H, Valero V, Hannessy B, Green M, Singletary E, Hortobagyi GN, Pusztai L: A new measurement of residual cancer burden to predict survival after neoadjuvant chemotherapy. Proc Am Soc Clin Oncol. 2006, 24: A536- Symmans W, Peintinger F, Hatzis C, Kuere H, Valero V, Hannessy B, Green M, Singletary E, Hortobagyi GN, Pusztai L: A new measurement of residual cancer burden to predict survival after neoadjuvant chemotherapy. Proc Am Soc Clin Oncol. 2006, 24: A536-
16.
go back to reference Paik S: Importance of obtaining tissue for research – a case study in NSABP B27. Presented at National Cancer Institute meeting 'Preoperative Therapy in Invasive Breast Cancer: Reviewing the State of the Science and Exploring New Research Directions', Bethesda, MD, 26–27. 2007, March Paik S: Importance of obtaining tissue for research – a case study in NSABP B27. Presented at National Cancer Institute meeting 'Preoperative Therapy in Invasive Breast Cancer: Reviewing the State of the Science and Exploring New Research Directions', Bethesda, MD, 26–27. 2007, March
17.
go back to reference Kaufmann M, Hortobagyi GN, Goldhirsch A, Scholl S, Makris A, Valagussa P, Blohmer JU, Eiermann W, Jackesz R, Jonaz W, et al: Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: an update. J Clin Oncol. 2006, 24: 1940-1949. 10.1200/JCO.2005.02.6187.CrossRefPubMed Kaufmann M, Hortobagyi GN, Goldhirsch A, Scholl S, Makris A, Valagussa P, Blohmer JU, Eiermann W, Jackesz R, Jonaz W, et al: Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: an update. J Clin Oncol. 2006, 24: 1940-1949. 10.1200/JCO.2005.02.6187.CrossRefPubMed
18.
go back to reference Thomas E, Holmes FA, Smith TL, Buzdar AU, Fyre DK, Fraschini G, Singletary SE, Theriault RL, McNeese MD, Ames F, et al: The use of alternate, non-cross-resistant adjuvant chemotherapy on the basis of pathologic response to a neoadjuvant doxorubicin-based regimen in women with operable breast cancer: long-term results from a prospective randomized trial. J Clin Oncol. 2004, 22: 2294-2302. 10.1200/JCO.2004.05.207.CrossRefPubMed Thomas E, Holmes FA, Smith TL, Buzdar AU, Fyre DK, Fraschini G, Singletary SE, Theriault RL, McNeese MD, Ames F, et al: The use of alternate, non-cross-resistant adjuvant chemotherapy on the basis of pathologic response to a neoadjuvant doxorubicin-based regimen in women with operable breast cancer: long-term results from a prospective randomized trial. J Clin Oncol. 2004, 22: 2294-2302. 10.1200/JCO.2004.05.207.CrossRefPubMed
19.
go back to reference Ionta M, Atzori F, Scanu A, Scanni A, Cortesi E, Calluri A, Di Costanzo F, Maiorino L, Minerba L, Massidda B, et al: Induction and reinduction chemotherapy following standard treatment in stage IIIB breast cancer patients achieving less than pCR (<pCR) after primary chemotherapy: results from a pilot Italian study (ICARO 1). Breast Cancer Res Treat. 2006, 100: S156- Ionta M, Atzori F, Scanu A, Scanni A, Cortesi E, Calluri A, Di Costanzo F, Maiorino L, Minerba L, Massidda B, et al: Induction and reinduction chemotherapy following standard treatment in stage IIIB breast cancer patients achieving less than pCR (<pCR) after primary chemotherapy: results from a pilot Italian study (ICARO 1). Breast Cancer Res Treat. 2006, 100: S156-
20.
go back to reference von Minckwitz G, Blohmer JU, Raab G, Lohr A, Gerber B, Heinrich G, Eidtmann H, Kaufmann M, Hilfrich J, Jackisch C, et al: In vivo chemosensitivity-adapted preoperative chemotherapy in patients with early-stage breast cancer: the GEPARTRIO pilot study. Ann Oncol. 2005, 16: 56-63. 10.1093/annonc/mdi001.CrossRefPubMed von Minckwitz G, Blohmer JU, Raab G, Lohr A, Gerber B, Heinrich G, Eidtmann H, Kaufmann M, Hilfrich J, Jackisch C, et al: In vivo chemosensitivity-adapted preoperative chemotherapy in patients with early-stage breast cancer: the GEPARTRIO pilot study. Ann Oncol. 2005, 16: 56-63. 10.1093/annonc/mdi001.CrossRefPubMed
21.
go back to reference Hurwitz H, Fefrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, Berlin J, Baron A, Griffing S, Holmgren E, et al: Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med. 2004, 350: 2335-2342. 10.1056/NEJMoa032691.CrossRefPubMed Hurwitz H, Fefrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, Berlin J, Baron A, Griffing S, Holmgren E, et al: Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med. 2004, 350: 2335-2342. 10.1056/NEJMoa032691.CrossRefPubMed
22.
go back to reference Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, Lilenbaum R, Johnson DH: Randomized phase II/III trial of paclitaxel (P) plus carboplatin (C) with or without bevacizumab (NSC #704865) in patients with advanced non-squamous non-small cell lung cancer (NSCLC): an Eastern Cooperative Oncology Group (ECOG) Trial – E4599. N Engl J Med. 2006, 355: 2542-2550. 10.1056/NEJMoa061884.CrossRefPubMed Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, Lilenbaum R, Johnson DH: Randomized phase II/III trial of paclitaxel (P) plus carboplatin (C) with or without bevacizumab (NSC #704865) in patients with advanced non-squamous non-small cell lung cancer (NSCLC): an Eastern Cooperative Oncology Group (ECOG) Trial – E4599. N Engl J Med. 2006, 355: 2542-2550. 10.1056/NEJMoa061884.CrossRefPubMed
23.
go back to reference Miller KD, Chap LI, Holmes FA, Cobleigh MA, Marcom PK, Fehrenbacher L, Dickler M, Overmoyer BA, Reimann JD, Sing AP, et al: Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer. J Clin Oncol. 2005, 23: 792-799. 10.1200/JCO.2005.05.098.CrossRefPubMed Miller KD, Chap LI, Holmes FA, Cobleigh MA, Marcom PK, Fehrenbacher L, Dickler M, Overmoyer BA, Reimann JD, Sing AP, et al: Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer. J Clin Oncol. 2005, 23: 792-799. 10.1200/JCO.2005.05.098.CrossRefPubMed
24.
go back to reference Miller K, Wang M, Gralow J, Dickler M, Cobleigh M, Perez E, Shenkier T, Davidson N: A randomized phase III trial of paclitaxel versus paclitaxel plus bevacizumab as first-line therapy for locally recurrent or metastatic breast cancer: a trial coordinated by the Eastern Cooperative Oncology Group (E2100). Breast Cancer Res Treat. 2005, 94: S6- Miller K, Wang M, Gralow J, Dickler M, Cobleigh M, Perez E, Shenkier T, Davidson N: A randomized phase III trial of paclitaxel versus paclitaxel plus bevacizumab as first-line therapy for locally recurrent or metastatic breast cancer: a trial coordinated by the Eastern Cooperative Oncology Group (E2100). Breast Cancer Res Treat. 2005, 94: S6-
25.
go back to reference Burstein H, Spigel D, Kindsvogel K, Parker L, Bunnell C, Partridge A, Come S, Ryan P, Gelman R, Winer E: Metronomic chemotherapy with and without bevacizumab for advanced breast cancer: a randomized phase II study. Breast Cancer Res Treat. 2005, 94 (Suppl 1): S6- Burstein H, Spigel D, Kindsvogel K, Parker L, Bunnell C, Partridge A, Come S, Ryan P, Gelman R, Winer E: Metronomic chemotherapy with and without bevacizumab for advanced breast cancer: a randomized phase II study. Breast Cancer Res Treat. 2005, 94 (Suppl 1): S6-
26.
go back to reference Mayer E, Miller K, Rugo H, Peppercorn J, Carey L, Ryabin N, Winer E, Burstein H: A pilot study of adjuvant bevacizumab after neoadjuvant chemotherapy for high-risk breast cancer. Proc Am Soc Clin Oncol. 2006, 25: 56- Mayer E, Miller K, Rugo H, Peppercorn J, Carey L, Ryabin N, Winer E, Burstein H: A pilot study of adjuvant bevacizumab after neoadjuvant chemotherapy for high-risk breast cancer. Proc Am Soc Clin Oncol. 2006, 25: 56-
Metadata
Title
Clinical trial update: implications and management of residual disease after neoadjuvant therapy for breast cancer
Authors
Erica L Mayer
Lisa A Carey
Harold J Burstein
Publication date
01-10-2007
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 5/2007
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/bcr1755

Other articles of this Issue 5/2007

Breast Cancer Research 5/2007 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine