Clinical Edge Journal Scan

Neoadjuvant ET: A reasonable standard-of-care in stage II/III ER+ BC


 

Key clinical point: In patients with stage II/III estrogen receptor-positive (ER+) breast cancer (BC), neoadjuvant endocrine therapy (ET) with aromatase inhibitors downstaged a fair proportion of tumors to allow breast-conserving surgery (BCS) and resulted in low local-regional recurrence rates.

Major finding: After receiving neoadjuvant ET, local-regional recurrence rates were low (1.53%) and 50.4% of the 226 patients who were thought to require a mastectomy or have an inoperable BC underwent BCS.

Study details: Findings are from an analysis of the phase 2, American College of Surgeons Oncology Group Z1031 trial including 509 postmenopausal women with invasive, stage II/III, ER+ BC who received exemestane, anastrozole, or letrozole for 16-18 weeks.

Disclosures: This study was supported by the National Cancer Institute of the US National Institutes of Health. The authors declared serving as employees, consultants, or advisors or receiving research funding from various sources.

Source: Hunt KK et al. Local-regional recurrence after neoadjuvant endocrine therapy: Data from ACOSOG Z1031 (Alliance), a randomized phase 2 neoadjuvant comparison between letrozole, anastrozole, and exemestane for postmenopausal women with estrogen receptor-positive clinical stage 2 or 3 breast cancer. Ann Surg Oncol. 2023 (Jan 18). Doi: 10.1245/s10434-022-12972-5

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