More than a decade of giving neoadjuvant therapy in an Australian breast cancer setting: what have we learned?

Alysson Wann, Sophie Wann, Josephine Stewart, Frances Barnett, David Williams, Belinda Yeo

Research output: Contribution to journalMeeting Abstractpeer-review

Abstract

Background: Neoadjuvant chemotherapy has been shown to result in similar survival outcomes to adjuvant chemotherapy in breast cancer patients with nonmetastatic breast cancer1, 2. The known benefits of neoadjuvant therapies are predominantly to downstage or facilitate surgery and to provide information on the biological response of the tumor to treatment. Response to neoadjuvant therapy, such as attaining a pathological complete response, has been shown to improve survival outcomes. However, more recently, there are newer arguments emerging to support the use of neoadjuvant therapy such as the ability to facilitate early reconstruction.
Aims: The aim of this retrospective study was to evaluate patient selection, clinicopathological characteristics, surgical outcomes and survival over the past decade of treating patients with neoadjuvant chemotherapy at both The Austin and Northern Hospitals.
Methods: Neoadjuvant patients were identified from histopathology databases between 2004 and 2016 and were eligible for this analysis if they were nonmetastatic at the time of commencing treatment. Clinicopathological characteristics, treatment intent, survival and surgical outcomes were recorded.
Results: Eighty-five patients with a mean age of 50 years at diagnosis. Nearly half (45%) of the breast cancers were T3 or T4 tumor size at baseline. Sixty-four percent of patients had estrogen-receptor (ER) positive disease, 32% had HER2 positive disease and 17% had triple negative disease. Approximately 10% of treated patients were deemed inoperable at diagnosis. The vast majority (82%) of all patients underwent mastectomy. Ninety percent of patients received third-generation chemotherapy regimens and nearly all HER2 positive patients received adjuvant trastuzumab. The pathological complete response rate was approximately 20%. Further results detailing surgical downstaging and uptake of immediate reconstructive surgery will be presented. One in four patients had a relapse event and 21% of patients had died with breast cancer recurrence.
Conclusion: This series describes our experience of using neoadjuvant chemotherapy in high-risk, nonmetastatic patients. In this constantly evolving field particularly with the introduction of neoadjuvant targeted therapy in HER2-positive patients, there are emerging indications to consider neoadjuvant treatment that require further exploration.
Original languageEnglish
Article number261
Pages (from-to)133-134
Number of pages2
JournalAsia-Pacific Journal of Clinical Oncology
Volume12
Issue numberS5
Publication statusPublished - Nov 2016
Externally publishedYes
EventClinical Oncology Society of Australia Annual Scientific Meeting 2016: Partners for Progress in Breast Cancer Research and Care - Gold Coast Convention & Exhibition Centre, Broadbeach, Australia
Duration: 15 Nov 201617 Nov 2016
Conference number: 43rd
https://onlinelibrary.wiley.com/toc/17437563/2016/12/S5 (published program)
https://onlinelibrary.wiley.com/doi/10.1111/ajco.12646

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