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Adding Adjuvant Systemic Treatment after Neoadjuvant Therapy in Breast Cancer: Review of the Data

  • Breast Cancer (B Overmoyer, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Residual disease after neoadjuvant chemotherapy is a poor prognostic factor; however, proven strategies to reduce recurrence risk and improve overall survival in this patient population are limited. Previous studies of residual disease have illustrated the importance of tumor intrinsic subtypes in treatment response and mechanisms of resistance. This review summarizes the rationale for various therapeutic approaches as well as completed and ongoing clinical trials for this high-risk group of patients.

Recent Findings

Regimens utilizing additional chemotherapy and targeted therapies (such as PARP inhibitors or bisphosphonates) have met with limited efficacy. Notably, a recently published randomized study of capecitabine in patients with residual disease demonstrated an improvement in disease-free survival and overall survival.

Summary

While the results for capecitabine are promising, particularly for patients with triple-negative disease, the generalizability of these findings is an open question. Meanwhile, ongoing trials with novel agents that target specific tumor subtypes and the biology of residual disease may improve outcomes for other patient populations.

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Authors and Affiliations

  1. Perelman Center for Advanced Medicine, 10th floor, South Tower, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19072, USA

    Shetal A. Patel & Angela DeMichele

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  1. Shetal A. Patel
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  2. Angela DeMichele
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Correspondence to Angela DeMichele.

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Conflict of Interest

Shetal A. Patel declares that she has no conflict of interest.

Angela DeMichele has served on advisory boards for and received institutional research support from Calithera Biosciences, Pfizer, and Novartis.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Breast Cancer

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Patel, S.A., DeMichele, A. Adding Adjuvant Systemic Treatment after Neoadjuvant Therapy in Breast Cancer: Review of the Data. Curr Oncol Rep 19, 56 (2017). https://doi.org/10.1007/s11912-017-0613-6

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  • DOI: https://doi.org/10.1007/s11912-017-0613-6

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