In vivo chemosensitivity adapted preoperative chemotherapy in patients with early stage breast cancer: the Gepartrio pilot study

Minckwitz, G von; Loibl, Sibylle

doi:10.1093/annonc/mdi283

Cited by 46 publications

(69 citation statements)

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“…53 The cCR rates in the 2 arms were 22.5% and 21.9%, respectively, whereas the pCR rates were 7.3% and 3.1%, respectively (no P values were provided). Further accrual into the Phase III study should allow a more thorough analysis.…”

Section: Neoadjuvant Chemotherapy Regimens With Sequential or Alternamentioning

confidence: 97%

Preoperative chemotherapy treatment of breast cancer—A review

Buzdar

2007

Cancer

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Despite proven benefits of neoadjuvant chemotherapy in patients with locally advanced, invasive breast cancer, no regimen is recommended as the treatment of choice. Neoadjuvant chemotherapy regimens encompass single-agent and combination therapy and sequential treatment. For this report, the author reviewed the literature to determine which regimen, if any, was most beneficial.The results indicated that studies have yielded a wide range of response rates, but no single regimen has emerged as a clear leader. The literature is compounded further by lack of standardized criteria to determine pathologic complete response (which is predictive of survival benefits) and between-study variation in the stringency by which this endpoint is defined. Given the lack of a preferred treatment regimen in the neoadjuvant setting, identifying patients who are likely to respond to specific agents could inform treatment decisions, improve treatment outcomes, and aid in avoiding unnecessary exposure to potential toxicities. The development of novel agents for use alone or in combination with existing agents may improve response rates further in the neoadjuvant setting, especially because a significant proportion of breast tumors can be resistant to many current antineoplastic agents. Particularly noteworthy are the epothilones and their analogs because of their low susceptibility to common tumor-resistance mechanisms. Initial data have indicated that ixabepilone, which is an epothilone analog, has activity in the neoadjuvant setting, and predictive factors for response have been identified. The future of neoadjuvant therapy lies in tailoring treatment to individual patients by identifying response predictors and developing novel agents. This ultimately may lead to improved outcomes for women with breast cancer.

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Section: Neoadjuvant Chemotherapy Regimens With Sequential or Alternamentioning

confidence: 97%

Preoperative chemotherapy treatment of breast cancer—A review

Buzdar

2007

Cancer

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“…Between 1998 and 2006, a total of eight major prospective neoadjuvant trials in 6625 breast cancer patients were conducted in Germany [9,10,11,12,13,14,15,16,17,18]. Details of design and conduct of individual trial were previously reported (Table 1).…”

Section: Patientsmentioning

confidence: 99%

“…Seven trials were phase III randomized parallel-group trials (6408 patients) [9][10][11][12][13][14][15][16][17] and one was a phase II case series (217 patients) [18] In the GeparTrio main trial [12,13], the 622 non-responders were randomized to 4 further cycles of TAC (321 patients) or 4 cycles of NX (301 patients), whereas the 1390 responders were allocated to 4 or 6 further cycles of TAC (704 and 686 patients, respectively). To avoid confounding by treatment selection according to intermediate clinical assessment of tumor response, we excluded the 334 patients allocated to NX, a proportional random sample of 95 responders, who received a total of 6 cycles of TAC in the GeparTrio pilot trial [11], and the 686 responders, who received a total of 8 cycles of TAC in the GeparTrio main trial [12,13]. 134 patients included in the run-in period of GeparTrio [12,13] and GeparQuattro [14,15] who dropped out before randomization because of progression, malcompliance, or side-effects, were analyzed in actual treatment arms as determined by computer-generated random allocation.…”

Section: Patientsmentioning

confidence: 99%

Impact of treatment characteristics on response of different breast cancer phenotypes: pooled analysis of the German neo-adjuvant chemotherapy trials

Minckwitz

Untch

Nüesch

et al. 2010

Breast Cancer Res Treat

243

129

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2 Abstract PurposePathological complete response (pCR) to neoadjuvant treatment correlates with outcome in breast cancer. We determined whether characteristics of neoadjuvant therapy are associated with pCR. MethodsWe used multi-level models, which accounted for heterogeneity in pCR across trials and trial arms, to analyze individual patient data from 3332 women included in 7 German neoadjuvant trials with uniform protocols.

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“…Neoadjuvant chemotherapy has the same goal and may in addition enable breast-preserving surgery [2,3]. Large breast tumors are frequently considered for neoadjuvant chemotherapy regardless of other characteristics and without debate on survival benefit.…”

Section: Introductionmentioning

confidence: 99%

In the Era of Genomics, Should Tumor Size Be Reconsidered as a Criterion for Neoadjuvant Chemotherapy?

et al. 2015

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Background. The Oncotype DX recurrence score (RS) assay has been validated for prediction of 10-year risk of distant recurrence and likelihood of benefit from chemotherapy in patients with estrogen receptor (ER)-positive, HER2-negative early breastcancer. Patients with high RS tumors have substantial benefit, and patients with low RS tumors have minimal if any benefit from chemotherapy. Tumor size is used as a key parameter when selecting patients for neoadjuvant chemotherapy. The aim of this study was to assess the distribution of RS in patients selected for neoadjuvant chemotherapy primarily according to tumor size. Patients and Methods. Patients with ER-positive and HER2-negative tumors that were node-negative or had no more than 1 positive node from three trials were included in this study. Oncotype DX was performed at Genomic Health, Inc., blinded

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In vivo chemosensitivity adapted preoperative chemotherapy in patients with early stage breast cancer: the Gepartrio pilot study

Cited by 46 publications

References 1 publication

Preoperative chemotherapy treatment of breast cancer—A review

Preoperative chemotherapy treatment of breast cancer—A review

Impact of treatment characteristics on response of different breast cancer phenotypes: pooled analysis of the German neo-adjuvant chemotherapy trials

In the Era of Genomics, Should Tumor Size Be Reconsidered as a Criterion for Neoadjuvant Chemotherapy?

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