Journal of Oncology / 2013 / Article / Tab 1 / Review Article
Neoadjuvant Chemotherapy and Targeted Therapy in Breast Cancer: Past, Present, and Future Table 1 Trials comparing the same chemotherapeutic regimen pre- and postoperatively.
Trial Phase (
) Tumors NA versus adjuvant Primary endpoint Other outcomes Ref. IBBGS III (272) T2 > 3 cm or T3 N0-1 3 × EVM → 3 × ETV BCT 63% (33% RT only, 30% S + RT) versus 0% No difference in DFS or OS; 34% local recurrence with RT only [40 , 41 ] Institut Curie S6 III (390) T2-3, N0-1 4 × FAC BCT 82 versus 77% (ns) (S only if no cCR after RT) No difference in DFS and OS, short-term OS benefit (
) for NA [42 , 43 ] Royal Marsden III (293) T0–4, N0-1 4 × 2MT BCT 89 versus 78% (
) No difference in DFS, OS, and local recurrence; pCR 7% [44 , 45 ] NSABP B-18 III (1493) T1–3, N0-1 4 × AC 5 y-OS: 80 versus 81% (ns); 5 y-DFS: 67 versus 67% (ns) BCT 68 versus 60% (
); LRR 13 versus 10% (
); ORR 78%, pCR 13%; pCR associated with better 9 y-DFS (75 versus 58%) pCR associated with better 9 y-OS (85 versus 73%); trends in favor of NA for DFS and OS in women <50 y [1 , 46 , 47 ] EORTC 10902 III (698) T1c–T4b 4 × FEC 4 y-OS 82 versus 84% (
) 4 y-PFS 65 versus 70% (
); LRR 5 versus 5% (ns); pCR 4%; downstaging to BCT in 23% [2 ] ABCSG-7 III (423) T1–3, N0-1 HR− + high risk HR+ 3 × CMF RFS better with adjuvant therapy (HR 0.7;
); no difference in OS (HR 0.8;
) cORR 56%, pCR 6%; LRR 13 versus 8% (
) [48 ] Meta-analysis IV (3946) 9 randomized trials Same regimen No difference in OS (RR 1.0); no difference in DFS (RR 0.99) LRR higher for NA (RR 1.22;
) especially if no S was done; pCR range 4–29% [3 ]
EVM: epirubicin, vincristin, methotrexat; ETV: mitomycin, thiotepa, vindesine; FAC: 5-FU, doxorubicin, cyclophosphamide; 2MT: mitoxantrone, methotrexat, tamoxifen; AC: doxorubicin, cyclophosphamide; FEC: 5-FU, epirubicin, cyclophosphamide; CMF: cyclophosphamide, methotrexat, 5-FU.