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Chimiothérapie néoadjuvante : pour qui ?

Neoadjuvant chemotherapy: for whom?

  • Mise Au Point / Update
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Oncologie

Résumé

La chimiothérapie néoadjuvante (CNA) était initialement utilisée en cas de cancers du sein inflammatoires ou de tumeurs inopérables. Progressivement, les indications se sont étendues à des stades plus précoces et donc à des cancers du sein opérables. Il n’y a à ce jour pas d’impact démontré sur la survie globale ou sans récidive. Le bénéfice de la CNA porte avant tout sur l’augmentation des possibilités de traitement chirurgical conservateur et sur l’amélioration du résultat esthétique. La CNA permet également d’évaluer la chimiosensibilité à travers la réponse pathologique complète (pCR), facteur prédictif de meilleur pronostic. La réponse à la CNA est liée à la biologie tumorale, et une chirurgie avec oncoplastie peut parfois être une alternative à une CNA en cas de tumeur peu chimiosensible. Une connaissance et une évaluation multidisciplinaire sont donc nécessaires à la prise en charge optimale de ces patientes.

Abstract

Initially, neoadjuvant chemotherapy (NAC) was used in inflammatory breast cancers and inoperable tumors. More recently, indications have been spread to earlier stages and operable breast cancers. No effect on overall survival has been demonstrated. The benefits of NAC include an increase in the conservative surgical treatment rate and improved aesthetic results. NAC allows the evaluation of chemosensitivity through the pathological complete response (pCR), predictive factor for better prognostic. Response to NAC is linked to tumor biology, and oncoplastic surgery can be an alternative to NAC. A multidisciplinary assessment is needed for optimal management of these patients.

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  1. Centre Oscar-Lambret, 3, rue Frédéric-Combemale, F-59000, Lille, France

    M. P. Chauvet & A. Mailliez

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  1. M. P. Chauvet
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  2. A. Mailliez
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Correspondence to M. P. Chauvet or A. Mailliez.

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Chauvet, M.P., Mailliez, A. Chimiothérapie néoadjuvante : pour qui ?. Oncologie 18, 115–119 (2016). https://doi.org/10.1007/s10269-016-2590-z

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  • DOI: https://doi.org/10.1007/s10269-016-2590-z

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