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Neoadjuvant Endocrine Therapy in Clinical Practice: A Review
Tal Sella1,2, Anna Weiss2,3, Elizabeth A Mittendorf2,3
1Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
JAMA Oncology
|September 9, 2021
Summary
Neoadjuvant endocrine therapy (NET) is an effective treatment for hormone receptor-positive breast cancer, enabling breast-conserving surgery. Increased use of NET is expected with evolving treatment strategies and gene expression profiling.
Area of Science:
- Oncology
- Breast Cancer Research
- Endocrine Therapy
Background:
- Neoadjuvant endocrine therapy (NET) is underutilized in clinical practice despite its efficacy in tumor downstaging and facilitating breast-conserving surgery.
- Hormone receptor (HR)-positive/ERBB2-negative breast cancer treatment is evolving, with NET showing significant potential.
Purpose of the Study:
- To provide a comprehensive review of clinical aspects concerning NET application in HR-positive/ERBB2-negative breast cancer.
- To address current controversies and practical considerations for NET implementation.
Main Methods:
- Systematic review of studies published since 2000 focusing on NET in HR-positive/ERBB2-negative breast cancer.
- Analysis of patient selection, regimen choice, treatment duration, response evaluation, and surgical considerations.
Main Results:
- NET is an optimal treatment for many postmenopausal women with HR-positive breast cancer.
- Gene expression profiling and novel agents are shaping the evolving treatment landscape for HR-positive breast cancer.
Conclusions:
- The use of NET is anticipated to increase due to advancements in treatment selection and novel therapeutic agents.
- Practical considerations for NET, including patient selection and surgical management, will become increasingly important.
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