Association of Pathologic Complete Response to Neoadjuvant Therapy in HER2-Positive Breast Cancer with Long-Term Outcomes: A Meta-Analysis

Authors: Broglio, K.R., Quintana, M etl al.

Source: JAMA Oncol. doi:10.1001/jamaoncol.2015.6113

www.ncbi.nlm.nih.gov/pubmed/26914222

There is a spectrum of breast cancer types, and this has resulted in a variety of adjuvant (postoperative) chemotherapy options for treatment. In order to evaluate the survival outcomes of these treatments, studies must include great numbers of patients over many years. This is often impractical to achieve. Broglio and colleagues noted that observation of survival following a specific neoadjuvant (preoperative) chemotherapy regimen may be a more manageable task.

The group conducted a meta-analysis (evaluation of all relevant clinical studies published in the literature) of HER2-targeted neoadjuvant chemotherapy trials. The focus was the impact of pCR on event-free survival (EFS). EFS was defined as the length of time until cancer recurrence, relapse or death from any cause. A total of 36 studies were included. Analysis of the studies demonstrated a unified improvement in EFS and overall survival (OS) for patients who had a pCR.

The investigators concluded that HER2-targeted neoadjuvant therapy resulted in improved survival when a pCR was achieved. This supports the use of this therapy in the preoperative setting and also opens the door for future survival studies to be conducted more easily.