Neoadjuvant endocrine therapy in postmenopausal women with HR+/HER2- breast cancer.
Expert Rev Anticancer Ther
; 23(1): 67-86, 2023 Jan.
Article
in English
| MEDLINE | ID: covidwho-2233031
ABSTRACT
INTRODUCTION:
While endocrine therapy is the standard-of-care adjuvant treatment for hormone receptor-positive (HR+) breast cancers, there is also extensive evidence for the role of pre-operative (or neoadjuvant) endocrine therapy (NET) in HR+ postmenopausal women. AREAS COVERED We conducted a thorough review of the published literature, to summarize the evidence to date, including studies of how NET compares to neoadjuvant chemotherapy, which NET agents are preferable, and the optimal duration of NET. We describe the importance of on-treatment assessment of response, the different predictors available (including Ki67, PEPI score, and molecular signatures) and the research opportunities the pre-operative setting offers. We also summarize recent combination trials and discuss how the COVID-19 pandemic led to increases in NET use for safe management of cases with deferred surgery and adjuvant treatments. EXPERT OPINION NET represents a safe and effective tool for the management of postmenopausal women with HR+/HER2- breast cancer, enabling disease downstaging and a wider range of surgical options. Aromatase inhibitors are the preferred NET, with evidence suggesting that longer regimens might yield optimal results. However, NET remains currently underutilised in many territories and institutions. Further validation of predictors for treatment response and benefit is needed to help standardise and fully exploit the potential of NET in the clinic.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Breast Neoplasms
/
COVID-19
Type of study:
Prognostic study
Limits:
Female
/
Humans
Language:
English
Journal:
Expert Rev Anticancer Ther
Journal subject:
Neoplasms
/
Therapeutics
Year:
2023
Document Type:
Article
Affiliation country:
14737140.2023.2162043
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