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. 2023 Mar;149(3):1195-1209.
doi: 10.1007/s00432-022-03938-x. Epub 2022 Apr 5.

Current clinical practice and outcome of neoadjuvant chemotherapy for early breast cancer: analysis of individual data from 94,638 patients treated in 55 breast cancer centers

O Ortmann  1 , J-U Blohmer  2 , N T Sibert  3 , S Brucker  4 , W Janni  5 , A Wöckel  6 , A Scharl  7 , S Dieng  8 , J Ferencz  8 , E C Inwald  9 , S Wesselmann  3 , C Kowalski  3 ; for 55 breast cancer centers certified by the German Cancer Society
Collaborators, Affiliations

Current clinical practice and outcome of neoadjuvant chemotherapy for early breast cancer: analysis of individual data from 94,638 patients treated in 55 breast cancer centers

O Ortmann et al. J Cancer Res Clin Oncol. 2023 Mar.

Abstract

Neoadjuvant chemotherapy (NACT) is frequently used in patients with early breast cancer. Randomized controlled trials have demonstrated similar survival after NACT or adjuvant chemotherapy (ACT). However, certain subtypes may benefit more when NACT contains regimes leading to high rates of pathologic complete response (pCR) rates. In this study we analyzed data using the OncoBox research from 94,638 patients treated in 55 breast cancer centers to describe the current clinical practice of and outcomes after NACT under routine conditions. These data were compared to patients treated with ACT. 40% of all patients received chemotherapy. The use of NACT increased over time from 5% in 2007 up to 17.3% in 2016. The proportion of patients receiving NACT varied by subtype. It was low in patients with HR-positive/HER2-negative breast cancer (5.8%). However, 31.8% of patients with triple-negative, 31.9% with HR-negative/HER2-positive, and 26.5% with HR-positive/HER2-positive breast cancer received NACT. The rates of pCR were higher in patients with HR-positive/HER2-positive, HR-negative/HER2-positive and triple-negative tumors (36, 53 and 38%) compared to HR-positive/HER2-negative tumors (12%). PCR was achieved more often in HER2-positive and triple-negative tumors over time.This is the largest study on use and effects of NACT in German breast cancer centers. It demonstrates the increased use of NACT based on recommendations in current clinical guidelines. An improvement of pCR was shown in particular in HER2-positive and triple-negative breast cancer, which is consistent with data from randomized controlled trails.

Keywords: Breast cancer centers; Early breast cancer; Guidelines; Neoadjuvant chemotherapy; Oncobox research.

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Conflict of interest statement

The authors have no conflict of interests related to the study.

Figures

Fig. 1
Fig. 1
Time-dependent use of NACT and adjuvant treatments. ACT adjuvant chemotherapy, NACT neoadjuvant chemotherapy, NACT_ACT neoadjuvant chemotherapy plus adjuvant chemotherapy
Fig. 2
Fig. 2
pCR by subtype over time, pCR pathologic complete remission
See this image and copyright information in PMC

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