Integrative review of clinical trials and meta-analysis of the main studies of neoadjuvant chemotherapy in the treatment of breast cancer in the past 30 years
Palavras-chave:
breast neoplasms, neoadjuvant therapy, chemotherapyResumo
Neoadjuvant chemotherapy (NAC) has become a common treatment strategy for early-stage breast cancer. In this study, we conducted a systematic research in the PubMed database using the following terms: breast cancer, neoadjuvant chemotherapy, randomized clinical trials, complete pathological response, overall survival, and disease-free survival. The research has been limited to articles published in the past 30 years (1993–2023). We included only randomized clinical trials that evaluated the use of NAC in breast cancer and data on PCR rates and survival outcomes. Our research resulted in a total of 13 randomized clinical trials and two meta-analyses. The PCR rates ranged from 13% to 58%, with higher rates observed in patients with triple-negative breast cancer (TNBC) and human epidermal growth factor 2 (HER-2+) disease. Several trials reveal a significant association between PCR and better survival results, including overall survival and disease-free survival. However, the impact of PCR on survival results was less consistent in patients with hormone receptor-positive breast cancer. The use of taxanes in combination with anthracyclines has been the most common NAC scheme evaluated in these trials. The PCR rates have been associated with better survival outcomes, in patients with TNBC and HER-2+ disease. However, the impact of PCR on survival outcomes in patients with hormone receptor-positive breast cancer is less clear. Additional studies are needed to determine the optimal NAC regimen for each subtype of breast cancer and to identify biomarkers that can predict the NAC response.
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Copyright (c) 2024 Marcelo Antonini, André Mattar, Gabriel Duque Pannain, Luiz Henrique Gebrim, Odair Ferraro, Reginaldo Coelho Guedes Lopes, Juliana Monte Real
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
