Skip to main content
SpringerLink
Log in

Ongoing Clinical Studies and Future Directions

  • Chapter
  • First Online:
Management of the Breast and Axilla in the Neoadjuvant Setting

  • 415 Accesses

Abstract

Systemic therapy in the neoadjuvant setting is commonplace for HER2+ disease, triple negative breast cancer (TNBC), and larger tumors in which downstaging is feasible. Current standard of practice regimens are being challenged by novel agents, the concept of neoadjuvant endocrine therapy, and approaches focusing on de-escalation of therapies both systemic and surgical. Key ongoing trials in this arena are summarized herein in individual hormone receptor positive, HER2+, and TNBC sections, in addition to sections pertaining to surgical management and novel strategies. The ongoing trials detailed provide insight into the direction toward which the field is moving, which include the adaptation of targeted therapies, as well as the utilization of histological parameters with sufficient negative predictive values to omit surgery in patients with pathologic complete response (pCR). These approaches also include the validation of molecular parameters that can be used as predictors of neoadjuvant efficacy, which are underway in current clinical trials. Quantification of circulating tumor DNA (ctDNA) constitutes a promising and seemingly reliable approach, which we will narrate in this chapter. These studies require reflective design to ultimately achieve realistic outcomes that do not come at the expense of suboptimal patient outcomes; therefore, stringent design is necessary. These novel perspectives may significantly contribute to optimize personalized treatment to reduce unfavorable outcomes derived from unrestrained cytotoxicity and futile interventions. This chapter seeks to provide current and evolving knowledge on the individualized management of women with early-stage breast cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fisher B, Brown A, Mamounas E, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol. 1997;15(7):2483–93. https://doi.org/10.1200/JCO.1997.15.7.2483.

    Article  CAS  PubMed  Google Scholar 

  2. Rastogi P, Anderson SJ, Bear HD, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27 [published correction appears in J Clin Oncol. 2008 Jun 1;26(16):2793]. J Clin Oncol. 2008;26(5):778–85. https://doi.org/10.1200/JCO.2007.15.0235.

    Article  PubMed  Google Scholar 

  3. Ellis MJ, Tao Y, Luo J, et al. Outcome prediction for estrogen receptor-positive breast cancer based on postneoadjuvant endocrine therapy tumor characteristics. J Natl Cancer Inst. 2008;100(19):1380–8. https://doi.org/10.1093/jnci/djn309.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Suman VJ, Ellis MJ, Ma CX. The ALTERNATE trial: assessing a biomarker driven strategy for the treatment of post-menopausal women with ER+/Her2- invasive breast cancer. Chin Clin Oncol. 2015;4(3):34. https://doi.org/10.3978/j.issn.2304-3865.2015.09.01.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ma CX, Suman VJ, Leitch AM, et al. ALTERNATE: neoadjuvant endocrine treatment (NET) approaches for clinical stage II or III estrogen receptor-positive HER2-negative breast cancer (ER+ HER2- BC) in postmenopausal (PM) women: Alliance A011106. J Clin Oncol. 2020;38(15_suppl):504. https://doi.org/10.1200/JCO.2020.38.15_suppl.504.

    Article  CAS  Google Scholar 

  6. Truin W, Vugts G, Roumen RM, et al. Differences in response and surgical management with neoadjuvant chemotherapy in invasive lobular versus ductal breast cancer. Ann Surg Oncol. 2016;23(1):51–7. https://doi.org/10.1245/s10434-015-4603-3.

    Article  CAS  PubMed  Google Scholar 

  7. Johnston S, Puhalla S, Wheatley D, et al. Randomized phase II study evaluating Palbociclib in addition to Letrozole as neoadjuvant therapy in estrogen receptor-positive early breast cancer: PALLET Trial. J Clin Oncol. 2019;37(3):178–89. https://doi.org/10.1200/JCO.18.01624.

    Article  CAS  PubMed  Google Scholar 

  8. Hurvitz SA, Martin M, Press MF, et al. Potent cell-cycle inhibition and upregulation of immune response with Abemaciclib and Anastrozole in neoMONARCH, phase II neoadjuvant study in HR+/HER2− breast cancer. Clin Cancer Res. 2020;26(3):566–80. https://doi.org/10.1158/1078-0432.CCR-19-1425.

    Article  CAS  PubMed  Google Scholar 

  9. Al-Saleh KA, Bounedjar A, Oukkal M, et al. Prediction of response to neoadjuvant hormonal therapy (NAHT) using upfront oncotype Dx recurrence score (RS): results from the SAFIA phase III trial. J Clin Oncol. 2020;38(15_suppl):594. https://doi.org/10.1200/JCO.2020.38.15_suppl.594.

    Article  Google Scholar 

  10. Puhalla S, Yothers G, Sing AP, Julian TB, Wolmark N, Jacobs SA. NSABP FB-13: An assessment of the biological and clinical effects of palbociclib with ovarian suppression and letrozole in the neoadjuvant treatment of pts (pts) with premenopausal (preM) estrogen-receptor positive/HER2-negative primary breast cancer [abstract]. Presented at the 2019 San Antonio Breast Cancer Symposium, San Antonio, TX, December 10–14, 2019. https://doi.org/10.1158/1538-7445.SABCS19-OT2-02-03.

  11. Loi S, McArthur HL, Harbeck N, et al. A phase III trial of nivolumab with neoadjuvant chemotherapy and adjuvant endocrine therapy in ER+/HER2- primary breast cancer: CheckMate 7FL. J Clin Oncol. 2020;38(15_suppl):TPS604. https://doi.org/10.1200/JCO.2020.38.15_suppl.TPS604.

    Article  Google Scholar 

  12. Cardoso F, Bardia A, Andre F, et al. KEYNOTE-756: randomized, double-blind, phase 3 study of pembrolizumab vs placebo combined with neoadjuvant chemotherapy and adjuvant endocrine therapy for high-risk, early-stage estrogen receptor–positive, human epidermal growth factor receptor 2–negative (ER+/HER2−) breast cancer. J Clin Oncol. 2019;37(15_suppl):TPS601. https://doi.org/10.1200/JCO.2019.37.15_suppl.TPS60.

    Article  Google Scholar 

  13. Harbeck N. Emerging strategies in neoadjuvant treatment of patients with HER2-positive early breast cancer. Breast. 2019;48(Suppl 1):S97–S102. https://doi.org/10.1016/S0960-9776(19)31134-8.

    Article  PubMed  Google Scholar 

  14. Gianni L, Pienkowski T, Im YH, et al. 5-year analysis of neoadjuvant pertuzumab and trastuzumab in patients with locally advanced, inflammatory, or early-stage HER2-positive breast cancer (NeoSphere): a multicentre, open-label, phase 2 randomised trial. Lancet Oncol. 2016;17(6):791–800. https://doi.org/10.1016/S1470-2045(16)00163-7.

    Article  CAS  PubMed  Google Scholar 

  15. NCCN Clinical Practice Guidelines in Oncology. Breast Cancer. Version 6.2020. Available at: https://www.nccn.org/professionals/physician_gls/pdf/breast_blocks.pdf.

  16. van Ramshorst MS, van der Voort A, van Werkhoven ED, et al. Neoadjuvant chemotherapy with or without anthracyclines in the presence of dual HER2 blockade for HER2-positive breast cancer (TRAIN-2): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2018;19(12):1630–40. https://doi.org/10.1016/S1470-2045(18)30570-9.

    Article  PubMed  Google Scholar 

  17. Slamon DJ, Eiermann W, Robert NJ, et al. Ten year follow-up of BCIRG-006 comparing doxorubicin plus cyclophosphamide followed by docetaxel (AC→T) with doxorubicin plus cyclophosphamide followed by docetaxel and trastuzumab (AC→TH) with docetaxel, carboplatin and trastuzumab (TCH) in HER2+ early breast cancer. [abstract]. Presented at the 2015 San Antonio Breast Cancer Symposium, San Antonio, TX, December 8–12, 2015. https://doi.org/10.1158/1538-7445.SABCS15-S5-04.

  18. Schneeweiss A, Chia S, Hickish T, et al. Pertuzumab plus trastuzumab in combination with standard neoadjuvant anthracycline-containing and anthracycline-free chemotherapy regimens in patients with HER2-positive early breast cancer: a randomized phase II cardiac safety study (TRYPHAENA). Ann Oncol. 2013;24(9):2278–84. https://doi.org/10.1093/annonc/mdt182.

    Article  CAS  PubMed  Google Scholar 

  19. Salgado R, Denkert C, Campbell C, et al. Tumor-infiltrating lymphocytes and associations with pathological complete response and event-free survival in her2-positive early-stage breast cancer treated with lapatinib and trastuzumab: a secondary analysis of the NeoALTTO Trial [published correction appears in JAMA Oncol. 2015 Jul;1(4):544] [published correction appears in JAMA Oncol. 2015 Nov;1(8):1172. Nucifero, Paolo [corrected to Nuciforo, Paolo]] [published correction appears in JAMA Oncol. 2019 Jan 1;5(1):122]. JAMA Oncol. 2015;1(4):448–54. https://doi.org/10.1001/jamaoncol.2015.0830.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Fernandez-Martinez A, Krop IE, Hillman DW, et al. Survival, pathologic response, and genomics in CALGB 40601 (Alliance), a neoadjuvant phase III trial of paclitaxel-trastuzumab with or without lapatinib in HER2-positive breast cancer. J Clin Oncol. 2020;38(35):4184–93. https://doi.org/10.1200/JCO.20.01276.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Campbell JI, Yau C, Krass P, et al. Comparison of residual cancer burden, American Joint Committee on Cancer staging and pathologic complete response in breast cancer after neoadjuvant chemotherapy: results from the I-SPY 1 TRIAL (CALGB 150007/150012; ACRIN 6657). Breast Cancer Res Treat. 2017;165(1):181–91. https://doi.org/10.1007/s10549-017-4303-8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kaufman B, Mackey JR, Clemens MR, et al. Trastuzumab plus anastrozole versus anastrozole alone for the treatment of postmenopausal women with human epidermal growth factor receptor 2-positive, hormone receptor-positive metastatic breast cancer: results from the randomized phase III TAnDEM study. J Clin Oncol. 2009;27(33):5529–37. https://doi.org/10.1200/JCO.2008.20.6847.

    Article  CAS  PubMed  Google Scholar 

  23. Montemurro F, Rossi V, Cossu Rocca M, et al. Hormone-receptor expression and activity of trastuzumab with chemotherapy in HER2-positive advanced breast cancer patients. Cancer. 2012;118(1):17–26. https://doi.org/10.1002/cncr.26162.

    Article  CAS  PubMed  Google Scholar 

  24. Tripathy D, Kaufman PA, Brufsky AM, et al. First-line treatment patterns and clinical outcomes in patients with HER2-positive and hormone receptor-positive metastatic breast cancer from registHER. Oncologist. 2013;18(5):501–10. https://doi.org/10.1634/theoncologist.2012-0414.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Rimawi MF, Mayer IA, Forero A, et al. Multicenter phase II study of neoadjuvant lapatinib and trastuzumab with hormonal therapy and without chemotherapy in patients with human epidermal growth factor receptor 2-overexpressing breast cancer: TBCRC 006. J Clin Oncol. 2013;31(14):1726–31. https://doi.org/10.1200/JCO.2012.44.8027.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Guarneri V, Dieci MV, Bisagni G, et al. De-escalated therapy for HR+/HER2+ breast cancer patients with Ki67 response after 2-week letrozole: results of the PerELISA neoadjuvant study. Ann Oncol. 2019;30(6):921–6. https://doi.org/10.1093/annonc/mdz055.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Harbeck N, Gluz O, Christgen M, et al. De-escalation strategies in Human Epidermal Growth Factor Receptor 2 (HER2)-positive early Breast Cancer (BC): final analysis of the West German Study Group adjuvant dynamic marker-adjusted personalized therapy trial optimizing risk assessment and therapy response prediction in early BC HER2- and hormone receptor-positive phase II randomized trial-efficacy, safety, and predictive markers for 12 weeks of neoadjuvant trastuzumab emtansine with or without Endocrine Therapy (ET) versus Trastuzumab Plus ET. J Clin Oncol. 2017;35(26):3046–54. https://doi.org/10.1200/JCO.2016.71.9815.

    Article  CAS  PubMed  Google Scholar 

  28. Masuda N, Ohtani S, Takano T, et al. A randomized, 3-arm, neoadjuvant, phase 2 study comparing docetaxel + carboplatin + trastuzumab + pertuzumab (TCbHP), TCbHP followed by trastuzumab emtansine and pertuzumab (T-DM1+P), and T-DM1+P in HER2-positive primary breast cancer. Breast Cancer Res Treat. 2020;180(1):135–46. https://doi.org/10.1007/s10549-020-05524-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. von Minckwitz G, Huang CS, Mano MS, et al. Trastuzumab emtansine for residual invasive HER2-positive breast cancer. N Engl J Med. 2019;380(7):617–28. https://doi.org/10.1056/NEJMoa1814017.

    Article  Google Scholar 

  30. Marti JLG, Hyder T, Nasrazadani A, Brufsky AM. The evolving landscape of HER2-directed breast cancer therapy. Curr Treat Options Oncol. 2020;21(10):82. Published 2020 Aug 7. https://doi.org/10.1007/s11864-020-00780-6.

    Article  PubMed  Google Scholar 

  31. Rugo HS, Seock-Ah I, Cardoso, et al. Phase 3 SOPHIA study of margetuximab + chemotherapy vs trastuzumab + chemotherapy in patients with HER2+ metastatic breast cancer after prior anti-HER2 therapies: second interim overall survival analysis [abstract]. Presented at the 2019 San Antonio Breast Cancer Symposium, San Antonio, TX, December 10–14, 2019. https://doi.org/10.1158/1538-7445.SABCS19-GS1-02.

  32. Bang YJ, Giaccone G, Im SA, et al. First-in-human phase 1 study of margetuximab (MGAH22), an Fc-modified chimeric monoclonal antibody, in patients with HER2-positive advanced solid tumors. Ann Oncol. 2017;28(4):855–61. https://doi.org/10.1093/annonc/mdx002.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Krop I. MARGetuximab Or Trastuzumab (MARGOT) (MARGOT). 2020. Available at: https://clinicaltrials.gov/ct2/show/NCT04425018. Accessed January 18, 2021.

  34. Modi S, Saura C, Yamashita T, et al. Trastuzumab deruxtecan in previously treated HER2-positive breast cancer. N Engl J Med. 2020;382(7):610–21. https://doi.org/10.1056/NEJMoa1914510.

    Article  CAS  PubMed  Google Scholar 

  35. Tsang JY, Au WL, Lo KY, et al. PD-L1 expression and tumor infiltrating PD-1+ lymphocytes associated with outcome in HER2+ breast cancer patients. Breast Cancer Res Treat. 2017;162(1):19–30. https://doi.org/10.1007/s10549-016-4095-2.

    Article  CAS  PubMed  Google Scholar 

  36. Müller P, Kreuzaler M, Khan T, et al. Trastuzumab emtansine (T-DM1) renders HER2+ breast cancer highly susceptible to CTLA-4/PD-1 blockade. Sci Transl Med. 2015;7(315):315ra188. https://doi.org/10.1126/scitranslmed.aac4925.

    Article  CAS  PubMed  Google Scholar 

  37. Iwata TN, Sugihara K, Wada T, Agatsuma T. [Fam-] trastuzumab deruxtecan (DS-8201a)-induced antitumor immunity is facilitated by the anti-CTLA-4 antibody in a mouse model. PLoS One. 2019;14(10):e0222280. Published 2019 Oct 1. https://doi.org/10.1371/journal.pone.0222280.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Emens LA, Esteva FJ, Beresford M, et al. Trastuzumab emtansine plus atezolizumab versus trastuzumab emtansine plus placebo in previously treated, HER2-positive advanced breast cancer (KATE2): a phase 2, multicentre, randomised, double-blind trial. Lancet Oncol. 2020;21(10):1283–95. https://doi.org/10.1016/S1470-2045(20)30465-4.

    Article  CAS  PubMed  Google Scholar 

  39. Koski GK, Koldovsky U, Xu S, et al. A novel dendritic cell-based immunization approach for the induction of durable Th1-polarized anti-HER-2/neu responses in women with early breast cancer. J Immunother. 2012;35(1):54–65. https://doi.org/10.1097/CJI.0b013e318235f512.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Lowenfeld L, Zaheer S, Oechsle C, et al. Addition of anti-estrogen therapy to anti-HER2 dendritic cell vaccination improves regional nodal immune response and pathologic complete response rate in patients with ERpos/HER2pos early breast cancer. Oncoimmunology. 2016;6(9):e1207032. Published 2016 Jul 1. https://doi.org/10.1080/2162402X.2016.1207032.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Schmid P, Adams S, Rugo HS, et al. Atezolizumab and nab-paclitaxel in advanced triple-negative breast cancer. N Engl J Med. 2018;379(22):2108–21. https://doi.org/10.1056/NEJMoa1809615.

    Article  CAS  PubMed  Google Scholar 

  42. Saji S, Mittendorf E, Harbeck N, et al. 3MO IMpassion031: results from a phase III study of neoadjuvant (neoadj) atezolizumab + chemo in early triple-negative breast cancer (TNBC). Ann Oncol. 2020;S1243-7534(20):43197. https://doi.org/10.1016/j.annonc.2020.10.024.

    Article  Google Scholar 

  43. Schmid P, Cortes J, Pusztai L, et al. Pembrolizumab for early triple-negative breast cancer. N Engl J Med. 2020;382(9):810–21. https://doi.org/10.1056/NEJMoa1910549.

    Article  CAS  PubMed  Google Scholar 

  44. Loibl S, O’Shaughnessy J, Untch M, et al. Addition of the PARP inhibitor veliparib plus carboplatin or carboplatin alone to standard neoadjuvant chemotherapy in triple-negative breast cancer (BrighTNess): a randomised, phase 3 trial. Lancet Oncol. 2018;19(4):497–509. https://doi.org/10.1016/S1470-2045(18)30111-6.

    Article  CAS  PubMed  Google Scholar 

  45. Bardia A, Mayer IA, Vahdat LT, et al. Sacituzumab Govitecan-hziy in refractory metastatic triple-negative breast cancer. N Engl J Med. 2019;380(8):741–51. https://doi.org/10.1056/NEJMoa1814213.

    Article  CAS  PubMed  Google Scholar 

  46. van der Voort A, Dezentjé VO, van der Steeg WA, et al. Image-guided de-escalation of neoadjuvant chemotherapy in HER2-positive breast cancer: the TRAIN-3 study [abstract]. Presented at the 2018 San Antonio Breast Cancer Symposium, San Antonio, TX, December 4–8, 2018. https://doi.org/10.1158/1538-7445.SABCS18-OT2-07-07.

  47. Prat A, Pascual T. Omission of surgery in clinically low-risk HER2positive breast cancer with high HER2 addiction and a complete response following standard anti-HER2-based neoadjuvant therapy (ELPIS). 2020. Available at: https://clinicaltrials.gov/ct2/show/NCT04578106. Accessed on: January 18, 2021.

  48. Bennett IC, Saboo A. The evolving role of vacuum assisted biopsy of the breast: a progression from fine-needle aspiration biopsy. World J Surg. 2019;43(4):1054–61. https://doi.org/10.1007/s00268-018-04892-x.

    Article  PubMed  Google Scholar 

  49. van Nijnatten TJA, Simons JM, Smidt ML, et al. A novel less-invasive approach for axillary staging after neoadjuvant chemotherapy in patients with axillary node-positive breast cancer by combining Radioactive Iodine Seed Localization in the Axilla With the Sentinel Node Procedure (RISAS): a Dutch Prospective Multicenter Validation Study. Clin Breast Cancer. 2017;17(5):399–402. https://doi.org/10.1016/j.clbc.2017.04.006.

    Article  PubMed  Google Scholar 

  50. Mamounas EP, Bandos H, White JR. NRG Oncology/NSABP B-51/RTOG 1304: Phase III trial to determine if chest wall and regional nodal radiotherapy (CWRNRT) post mastectomy (Mx) or the addition of RNRT to whole breast RT post breast-conserving surgery (BCS) reduces invasive breast cancer recurrence-free interval (IBCR-FI) in patients (pts) with pathologically positive axillary (PPAx) nodes who are ypN0 after neoadjuvant chemotherapy (NC). J Clin Oncol. 2019;37(15 suppl) https://doi.org/10.1200/JCO.2019.37.15_suppl.TPS600.

  51. McDonald BR, Contente-Cuomo T, Sammut SJ, et al. Personalized circulating tumor DNA analysis to detect residual disease after neoadjuvant therapy in breast cancer. Sci Transl Med. 2019;11(504):eaax7392. https://doi.org/10.1126/scitranslmed.aax7392.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Garcia-Murillas I, Chopra N, Comino-Méndez I, et al. Assessment of molecular relapse detection in early-stage breast cancer [published correction appears in JAMA Oncol. 2020 Jan 1;6(1):162]. JAMA Oncol. 2019;5(10):1473–8. https://doi.org/10.1001/jamaoncol.2019.1838.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Esserman LJ, Berry DA, DeMichele A, et al. Pathologic complete response predicts recurrence-free survival more effectively by cancer subset: results from the I-SPY 1 TRIAL–CALGB 150007/150012, ACRIN 6657. J Clin Oncol. 2012;30(26):3242–9. https://doi.org/10.1200/JCO.2011.39.2779.

    Article  PubMed  PubMed Central  Google Scholar 

  54. I-SPY2 Trial Consortium, Yee D, DeMichele AM, et al. Association of event-free and distant recurrence-free survival with individual-level pathologic complete response in neoadjuvant treatment of stages 2 and 3 breast cancer: three-year follow-up analysis for the I-SPY2 adaptively randomized clinical trial. JAMA Oncol. 2020;6(9):1355–62. https://doi.org/10.1001/jamaoncol.2020.2535.

    Article  Google Scholar 

Download references

Author information

Author notes

  1. Juan Luis Gomez Marti and Tara Hyder contributed equally with all other contributors.

Authors and Affiliations

  1. University of Pittsburgh Physicians, Pittsburgh, PA, USA

    Azadeh Nasrazadani, Tara Hyder & Adam M. Brufsky

  2. UPMC Hillman Cancer Center, Magee Women’s Hospital, Pittsburgh, PA, USA

    Azadeh Nasrazadani & Adam M. Brufsky

  3. Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Juan Luis Gomez Marti & Vikram Gorantla

Authors
  1. Azadeh Nasrazadani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juan Luis Gomez Marti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tara Hyder
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vikram Gorantla
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Adam M. Brufsky
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adam M. Brufsky .

Editor information

Editors and Affiliations

  1. Breast Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Atilla Soran

  2. Dana-Farber Harvard Cancer Centar, Brigham and Women’s Hospital, Boston, MA, USA

    Faina Nakhlis

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Nasrazadani, A., Marti, J.L.G., Hyder, T., Gorantla, V., Brufsky, A.M. (2022). Ongoing Clinical Studies and Future Directions. In: Soran, A., Nakhlis, F. (eds) Management of the Breast and Axilla in the Neoadjuvant Setting. Springer, Cham. https://doi.org/10.1007/978-3-030-88020-0_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-88020-0_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-88019-4

  • Online ISBN: 978-3-030-88020-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation