Connolly Roisin M, Stearns Vered
Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 1650 Orleans Street, CRB I, Room 153, Baltimore, MD 21287-0013, United States.
Eur J Pharmacol. 2013 Oct 5;717(1-3):58-66. doi: 10.1016/j.ejphar.2013.02.057. Epub 2013 Mar 29.
Compared to adjuvant chemotherapy, the administration of the same regimen in the neoadjuvant setting provides women with identical improvements in disease free and overall survival. Neoadjuvant chemotherapy may offer benefits to properly selected women such as broadening surgical options and enhancing the likelihood of breast conservation. Assessment of response to neoadjuvant chemotherapy provides women with an individualized estimate of prognosis. For example, a woman who achieves a complete pathological response following neoadjuvant chemotherapy has a very low risk of recurrence compared to a woman with similar tumor characteristics and a large residual disease. In this review we will provide a historical perspective and discuss the aims of neoadjuvant chemotherapy in primary operable breast cancer; as well as appropriate patient selection, treatment strategies, response monitoring, and postoperative care. We will also discuss the attractiveness of this approach to study the mechanism of action of standard and novel agents, and the role of predictive biomarkers of response to treatment and outcomes.
与辅助化疗相比，在新辅助治疗中使用相同的方案可为女性带来无病生存期和总生存期方面相同的改善。新辅助化疗可能会为经过适当选择的女性带来益处，例如拓宽手术选择范围并提高保乳的可能性。评估对新辅助化疗的反应可为女性提供个性化的预后估计。例如，与具有相似肿瘤特征但有大量残留病灶的女性相比，在新辅助化疗后实现完全病理缓解的女性复发风险非常低。在本综述中，我们将提供历史视角并讨论原发性可手术乳腺癌新辅助化疗的目的；以及合适的患者选择、治疗策略、反应监测和术后护理。我们还将讨论这种方法在研究标准药物和新型药物作用机制方面的吸引力，以及治疗反应和结果预测生物标志物的作用。
