Neoadjuvant Therapy of Breast Cancer

Abstract

Objective: To evaluate the frequency of neoadjuvant therapy (NT) in women with stage I-III breast cancer in Italy and whether it is influenced by biological characteristics, screening history, and geographic area. Methods: Data from the High Resolution Study conducted in 7 Italian cancer registries were used; they are a representative sample of incident cancers in the study period (2009)(2010)(2011)(2012)(2013). Included were 3546 women aged <85 years (groups <50, 50-69, 70-64, and 75+) with stage I-III breast cancer at diagnosis who underwent surgery. Women were classified as receiving NT if they received chemotherapy, target therapy, and/or hormone therapy before the first surgical treatment. Logistic models were built to test the association with biological and contextual variables. Results: Only 8.2% of women (290 cases) underwent NT; the treatment decreases with increasing age (14.5% in age <50 and 2.2% in age 75+), is more frequent in women with negative receptors (14.8%), HER2-positive (15.7%), and triplenegative (15.6%). The multivariable analysis showed the probability of receiving NT is higher in stage III (odds ratio [OR] 3.83; 95% confidence interval [CI] 2.83-5.18), luminal B (OR 1.87; 95% CI 1.27-2.76), triple-negatives (OR 1.88; 95% CI 1.15-3.08), and in symptomatic cancers (OR 1.98;. Use of NT varied among geographic areas: Reggio Emilia had the highest rates (OR 2.29; 95% CI 1.37-3.82) while Palermo had the lowest (OR 0.41; 95% CI 0.24-0.68). Conclusions: The use of NT in Italy is limited and variable. There are no signs of greater use in hospitals with more advanced care.

Neoadjuvant Dose-Dense Gemcitabine plus Docetaxel and Vinorelbine plus Epirubicin for Operable Breast Cancer

“…[1,2] It is believed to treat clinically undetectable micrometastases [3] and allows for monitoring of tumor response to therapy. [4] Neoadjuvant therapy has recently become more commonly used in patients with larger tumors and/or lymph node involvement at diagnosis.…”

Neoadjuvant Dose-Dense Gemcitabine plus Docetaxel and Vinorelbine plus Epirubicin for Operable Breast Cancer

“…[1,2] It is believed to treat clinically undetectable micrometastases[3] and allows for monitoring of tumor response to therapy. [4] Neoadjuvant therapy has recently become more commonly used in patients with larger tumors and/or lymph node involvement at diagnosis.…”