Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 May 16;21(10):3528.
doi: 10.3390/ijms21103528.

Neoadjuvant Endocrine Therapy in Breast Cancer: Current Knowledge and Future Perspectives

Giacomo Barchiesi  1 , Marco Mazzotta  2 , Eriseld Krasniqi  2 , Laura Pizzuti  2 , Daniele Marinelli  3 , Elisabetta Capomolla  2 , Domenico Sergi  2 , Antonella Amodio  2 , Clara Natoli  4 , Teresa Gamucci  5 , Enrico Vizza  6 , Paolo Marchetti  3   7 , Claudio Botti  8 , Giuseppe Sanguineti  9 , Gennaro Ciliberto  10 , Maddalena Barba  2 , Patrizia Vici  2
Affiliations
Review

Neoadjuvant Endocrine Therapy in Breast Cancer: Current Knowledge and Future Perspectives

Giacomo Barchiesi et al. Int J Mol Sci. .

Abstract

In locally advanced (LA) breast cancer (BC), neoadjuvant treatments have led to major achievements, which hold particular relevance in HER2-positive and triple-negative BC. Conversely, their role in hormone receptor positive (HR+), hormone epidermal growth factor 2 negative (HER2-) BC is still under debate, mainly due to the generally low rates of pathological complete response (pCR) and lower accuracy of pCR as predictors of long-term outcomes in this patient subset. While administration of neoadjuvant chemotherapy (NCT) in LA, HR+, HER2- BC patients is widely used in clinical practice, neoadjuvant endocrine therapy (NET) still retains an unfulfilled potential in the management of these subgroups, particularly in elderly and unfit patients. In addition, NET has gained a central role as a platform to test new drugs and predictive biomarkers in previously untreated patients. We herein present historical data regarding Tamoxifen and/or Aromatase Inhibitors and a debate on recent evidence regarding agents such as CDK4/6 and PI3K/mTOR inhibitors in the neoadjuvant setting. We also discuss key issues concerning the optimal treatment length, appropriate comparisons with NCT efficacy and use of NET in premenopausal patients.

Keywords: breast cancer; endocrine therapy; hormonal therapy; neoadjuvant treatments.

PubMed Disclaimer

Conflict of interest statement

G.B., M.M., E.K., D.M., E.C., D.S., A.A., E.V., P.M., G.S., G.C., M.B. declare no COI. LP received travel grants from Eisai, Roche, Pfizer, Novartis; speaker fees from Roche, Pfizer, Novartis, Gentili. C.N. received travel grants/personal fees from Pfizer, EISAI, Novartis, Merck Sharp and Dohme, AstraZeneca. T.G. received travel grants from Eisai, Roche, Pfizer, Novartis; speaker fees/advisory boards from Roche, Pfizer, Novartis, Gentili, Lilly. C.B. received travel grants from Roche. P.V. received travel grants from Eisai, Roche, Pfizer, Novartis; speaker fees/advisory boards from Roche, Pfizer, Novartis, Gentili.

References

    1. Perou C.M., Sørlie T., Eisen M.B., Van De Rijn M., Jeffrey S.S., Rees C.A., Pollack J.R., Ross U.T., Johnsen H., Akslen L.A., et al. Molecular portraits of human breast tumours. Nature. 2000;406:747–752. doi: 10.1038/35021093. - DOI - PubMed
    1. Sotiriou C., Neo S.Y., McShane L.M., Korn E.L., Long P.M., Jazaeri A., Martiat P., Fox S.B., Harris A.L., Liu E.T. Breast cancer classification and prognosis based on gene expression profiles from a population-based study. Proc. Natl. Acad. Sci. USA. 2003;100:10393–10398. doi: 10.1073/pnas.1732912100. - DOI - PMC - PubMed
    1. McGivney W.T. The National Comprehensive Cancer Network. Cancer. 1998;82:2057–2060. doi: 10.1002/(SICI)1097-0142(19980515)82:10+<2057::AID-CNCR14>3.0.CO;2-A. - DOI - PubMed
    1. Puglisi F., Follador A., Minisini A.M., Cardellino G.G., Russo S., Andreetta C., Di Terlizzi S., Piga A. Baseline staging tests after a new diagnosis of breast cancer: Further evidence of their limited indications. Ann. Oncol. 2005;16:263–266. doi: 10.1093/annonc/mdi063. - DOI - PubMed
    1. Liedtke C., Mazouni C., Hess K.R., André F., Tordai A., Mejia J.A., Symmans W.F., Gonzalez-Angulo A.M., Hennessy B., Green M., et al. Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer. J. Clin. Oncol. 2008;26:1275–1281. doi: 10.1200/JCO.2007.14.4147. - DOI - PubMed