Chemotherapy (CT) and hormonotherapy (HT) as neoadjuvant treatment in luminal breast cancer patients: results from the GEICAM/2006-03, a multicenter, randomized, phase-II study

Alba, Emilio; Calvo, Lourdes; Albanell, Joan; Haba, J. R. De la; Lanza, Angels Arcusa; Chacón, José Ignacio; Sánchez‐Rovira, Pedro; Plazaola, Arrate; García-Asenjo, José Antonio López; Bermejo, B.; Carrasco, Eva; Lluch, Aña

doi:10.1093/annonc/mds132

Cited by 178 publications

(153 citation statements)

References 40 publications

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“…In all these trials, patients were treated with anthracycline and taxane-based neoadjuvant chemotherapy; anti-HER2 therapy (trastuzumab or lapatinib) was administered for most patients with HER2 overexpression (Table 1). Detailed descriptions of these trials have been published elsewhere [15][16][17][18][19]. The 262 patients involved represented 73% of the 361 patients participating in the four trials combined.…”

Section: Study Populationmentioning

confidence: 99%

High Proliferation Predicts Pathological Complete Response to Neoadjuvant Chemotherapy in Early Breast Cancer

Alba

Lluch²,

Ribelles

et al. 2016

The Oncologist

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Background. In the neoadjuvant setting, changes in the proliferation marker Ki67 are associated with primary endocrine treatment efficacy, but its value as a predictor of response to chemotherapy is still controversial. Patients and Methods. We analyzed 262 patients with centralized basal Ki67 immunohistochemical evaluation derived from 4 GEICAM (Spanish Breast Cancer Group) clinicaltrialsofneoadjuvant chemotherapy for breast cancer. The objective was to identify the optimal threshold for Ki67 using the receiver-operating characteristic curve method to maximize its predictive value for chemotherapy benefit. We also evaluated the predictive role of the defined Ki67 cutoffs for molecular subtypes defined by estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2). Results. A basal Ki67 cutpoint of 50% predicted pathological complete response (pCR). Patients with Ki67 .50% achieved a

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Section: Study Populationmentioning

confidence: 99%

High Proliferation Predicts Pathological Complete Response to Neoadjuvant Chemotherapy in Early Breast Cancer

Alba

Lluch²,

Ribelles

et al. 2016

The Oncologist

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“…NET with AI in luminal tumors was compared to NA anthracycline and taxane-based CT in 2 studies [12,13]. The first was conducted exclusively in the postmenopausal setting, and the AI (anastrozole or exemestane) was administered for 3 months [13].…”

Section: Luminal Breast Cancermentioning

confidence: 99%

“…The first was conducted exclusively in the postmenopausal setting, and the AI (anastrozole or exemestane) was administered for 3 months [13]. In the second study, postmenopausal (or premenopausal under luteinizing hormone-releasing hormone analogs) patients received exemestane for 24 weeks [12]. Both trials showed a similar cRR and pCR rate with NET and CT, although in the second trial there was a trend for worse outcome in the endocrine arm for premenopausal patients and those with high Ki67.…”

Section: Luminal Breast Cancermentioning

confidence: 99%

Neoadjuvant Model as a Platform for Research in Breast Cancer and Novel Targets under Development in this Field

et al. 2018

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For decades, the neoadjuvant setting has provided a useful scenario for research in breast cancer. Historically, neoadjuvant clinical trials, either hormone therapy-based or chemotherapy-based, have tried to recapitulate the results of their counterpart adjuvant studies, but with smaller patient numbers, more rapid outcomes (clinical response and/or pathologic complete response (pCR)), together with additional biologic information. As for neoadjuvant chemotherapy trials, the increase in pCR rates has been recently accepted as an appropriate surrogate marker to accelerate drug approval in high-risk breast cancer patients. In this setting, with the exception of luminal A tumors, pCR has been associated with improved long-term outcomes, particularly when the analysis is based on specific trials for each breast cancer subtype. For luminal tumors receiving neoadjuvant endocrine therapy, Ki67 at 2-4 weeks and the preoperative endocrine prognostic index score are the most accepted intermediate markers of efficacy, which will be validated in ongoing larger trials. In this review, we describe the different neoadjuvant designs: from the classical randomized trials in which treatment is delivered for 6 or more months to short non-therapeutic presurgical studies lasting just 2 or 3 weeks. We also review the main neoadjuvant trials, either ongoing or completed, for luminal, triple-negative, and HER2-positive breast cancer. The translational effort and research of biomarkers conducted in these studies will be particularly addressed.

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“…Although several papers confirm a predictive impact of high Ki-67 with respect to an increase of pCR in the NACT setting [24], to a benefit from taxanes in addition to anthracyclines in the adjuvant setting [25,27,28] as well as to a benefit of NACT versus ET in the ‘luminal B' subtype [29], so far no predictive effect of Ki-67 for benefit of adjuvant CT+ET versus ET alone has been shown [30]. This is difficult to understand in view of the prognostic impact of pCR particularly in the luminal B-like but not in the luminal A disease [31].…”

Section: Ihc-based Classificationmentioning

confidence: 99%

Genomic Profiling in Luminal Breast Cancer

et al. 2013

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SummaryThe developments in gene expression analysis have made it possible to sub-classify hormone receptor-positive (luminal) breast cancer in different prognostic subgroups. This sub-classification is currently used in clinical routine as prognostic signature (e.g. 21-gene Onoctype DX®, 70-gene Mammaprint®). As yet, the optimal method for sub-classification has not been defined. Moreover, there is no evidence from prospective trials. This review explores widely used genomic signatures in luminal breast cancer, making a critical appraisal of evidence from retrospective/prospective trials. It is based on systematic literature search performed using Medline (accessed September 2013) and abstracts presented at the Annual Meeting of American Society of Clinical Oncology and San Antonio Breast Cancer Symposium.

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Chemotherapy (CT) and hormonotherapy (HT) as neoadjuvant treatment in luminal breast cancer patients: results from the GEICAM/2006-03, a multicenter, randomized, phase-II study

Cited by 178 publications

References 40 publications

High Proliferation Predicts Pathological Complete Response to Neoadjuvant Chemotherapy in Early Breast Cancer

High Proliferation Predicts Pathological Complete Response to Neoadjuvant Chemotherapy in Early Breast Cancer

Neoadjuvant Model as a Platform for Research in Breast Cancer and Novel Targets under Development in this Field

Genomic Profiling in Luminal Breast Cancer

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