Review Article
Neoadjuvant Chemotherapy and Targeted Therapy in Breast Cancer: Past, Present, and Future
Table 2
Randomized trials incorporating either concurrent or sequential taxane-based neoadjuvant therapy.
| | Trial | Phase () | Tumors | Treatment | Primary endpoint | Other outcomes | Ref. |
| | Aberdeen trial | III (162) | ≥3 cm | 4 × CVAP → PR/CR: 4 × CVAP versus 4 × Doc; SD/PD: 4 × Doc | pCR 16 versus 34%; | cORR 66 versus 94%, ;
BCT 48 versus 67%;
5 y-OS (78 versus 93%, );
5 y-DFS (72 versus 90%, ) | [49, 50] |
| | NSABP B-27 | III (2411) | T1c–3 N0, T1–3 N1; (median 9 cm) | 4 × AC → S versus
4 × AC → 4 × Doc → S versus 4 × AC → S → 4 × Doc | DFS (arm 2 versus 1) HR 0.92 ();
OS ( across all 3 arms = .76);
RFI (arm 2 versus 1: HR 0.83, ) | LRR (arm 2/3 versus 1) HR 0.67 ();
BCT 62 versus 64% (ns),
ORR 86 versus 91% ();
pCR 9 versus 19% (),
pCR associated with better DFS (HR 0.49, ) and OS (HR 0.36, ) | [1, 51, 52] |
| | ACCOG | III (363) | ≥3 cm or T4d | 6 × AC versus
6 × ADoc | pCR 24 versus 21% ();
cORR 61 versus 70% () | No difference in RFS ();
no difference in OS () | [53] |
| | Diéras et al. | III (200) | T2-3 N0-1 | 4 × APac versus 4 × AC | pCR 16 versus 10% ( = NA) | cORR 89 versus 70%;
BCT 58 versus 45%;
DFS (18 MO: 87 versus 79%);
pCR associated with better DFS (31 MO: 91 versus 70%) | [54] |
| | Meta-analysis | IV (2455) | 7 randomized trials | Anthracycline-based therapy ± taxane | pCR better with sequential (RR 1.73, ), but not with concomitant taxanes (RR 1.04, );
BCT higher with taxanes (RR 1.11, ) | No difference in DFS (RR 0.91, ) | [6] |
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CVAP: cyclophosphamide, vincristin, doxorubicin, prednisone; Doc: doxetaxel; AC: docorubicin, cyclophosphamide; Pac: paclitaxel.
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