Neoadjuvant Endocrine Therapy May Be Alternative to Chemotherapy for Estrogen Receptor–Positive Breast Cance Interview with:

Aditya Bardia, MD, MPH Massachusetts General Hospital Cancer Center Harvard Medical School Boston, MA

Dr. Aditya Bardia

Aditya Bardia, MD, MPH
Massachusetts General Hospital Cancer Center
Harvard Medical School
Boston, MA What is the background for this study? What are the main findings?

Response: While endocrine therapy is the recommended therapy for Estrogen Receptor positive (ER+) breast cancer, the role of endocrine therapy in neoadjuvant (pre-surgical) setting is unclear. We performed this systematic review and meta-analysis to comprehensively evaluate the efficacy of neoadjuvant endocrine therapy, both alone and in combination with other therapies, compared to neoadjuvant chemotherapy for localized ER+ breast cancer. We found no statistically significant differences between the two treatments in regards to clinical response, imaging response, rates of breast conservation therapy, and achievement of pathologic complete response. What should readers take away from your report?

Response: Neoadjuvant (pre-surgical) endocrine therapy is associated with similar response rates as neoadjuvant combination chemotherapy but with significantly lower toxicity, suggesting that neoadjuvant endocrine therapy needs to be reconsidered as potential option in the appropriate setting. Also need to consider combination approach with targeted therapy in a clinical trial setting, to improve the response rates further. What recommendations do you have for future research as a result of this study?

Response: More biomarker-driven clinical trials of neoadjuvant endocrine therapy in combination with targeted therapies are needed, to help personalize the optimal therapeutic strategy for ER+ breast cancer. Thank you for your contribution to the community.


Neoadjuvant Endocrine Therapy for Estrogen Receptor–Positive Breast Cancer A Systematic Review and Meta-analysis

Laura M. Spring MD, Arjun Gupta MD, Kerry L. Reynolds MD, Michele A. Gadd MD, Leif W. Ellisen MD, PhD, Steven J. Isakoff MD, PhD, Beverly Moy MD, Aditya Bardia MD, MPH

JAMA Oncol. doi:10.1001/jamaoncol.2016.1897 Published online June 30, 2016.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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