Pre-Op Chemo-Survival No Better

Pre-Operative Endocrine Therapy Shows Promise For Breast Cancer [09/05/2001; Doctor's Guide]

Ongoing clinical trials show survival in breast cancer patients is equal between preoperative as with postoperative adjuvant therapies.

Preoperative (neoadjuvant) medical therapy has emerged over the past decade as a new approach for early breast cancer, points out Dr Ian Smith, Professor of Cancer Medicine, and colleagues at the Breast Unit, Royal Marsden Hospital, London England.

"Results show it has high activity, but survival is no better than with conventional adjuvant treatment," he and colleagues add in a detailed review of the state of neoadjuvant therapy.

"The need for mastectomy is reduced but not abolished; in some studies this effect is associated with a small increase in risk of local recurrence, but without any detriment to survival."

The aim is to define short-term surrogate markers predictive of long-term outcome. "Such markers may be biological rather than clinical, since the latter may prove too insensitive," Dr Smith points out. "If such markers can be established, then treatment can be individualised for each patient, with potential survival benefit.

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