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Neoadjuvant and adjuvant therapy in early breast cancer. A short review on current clinical approaches

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Summary

Early breast cancer (eBC) is a potentially curable disease. Its treatment is multimodal and includes surgery, radiotherapy and systemic therapy in either the neoadjuvant or the adjuvant setting. The treatment of eBC is an evolving field with a wealth of algorithms available, focusing on avoiding both over- and undertreatment. Molecular subtypes, genetic profiling, locoregional tumor load, patient age, comorbidities and the patient’s preferences all need to be taken into account when treating eBC. Recently, novel therapeutic options, including immune checkpoint inhibitors, cyclin-dependent kinase 4/6 (CDK4/6), and poly(ADP ribose)polymerase (PARP) inhibitors, have been approved in eBC. Besides these options for high-risk eBC, efforts have been made to de-escalate the use of cytotoxic chemotherapy, especially in hormone receptor-positive (HR+) eBC and HER2-positive (HER2+) eBC. This article summarizes recent developments in the systemic treatment of eBC.

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Abbreviations

AEs:

Adverse events

CDK 4/6:

Cyclin-dependent kinase 4/6

DRFS:

Distant relapse-free survival

eBC:

Early breast cancer

EFS:

Event-free survival

ET:

Endocrine therapy

HER2−:

HER2-negative

HER2+:

HER2-positive

HR+:

Hormone receptor-positive

IDFS:

Invasive disease-free survival

NACT:

Neoadjuvant chemotherapy

NNT:

Number needed to treat

PARP:

Poly(ADP ribose)polymerase

pCR:

Pathological complete response

RS:

Recurrence score

TNBC:

Triple-negative breast cancer

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Authors and Affiliations

  1. Department of Medicine I, Center for Oncology and Hematology, Vienna Healthcare Group, Clinic Ottakring, Montleartstraße 37, 1160, Vienna, Austria

    Simon Udovica & Kathrin Strasser-Weippl

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  1. Simon Udovica
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  2. Kathrin Strasser-Weippl
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Correspondence to Kathrin Strasser-Weippl.

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Conflict of interest

S. Udovica has received travel support from AOP Orphan and Roche, as well as Speakers’ honoraria from Servier; K. Strasser-Weippl has received travel support from Roche, Pfizer, Merck, Lilly, MSD and Speakers’ honoraria/Advisory boards from Roche, Pfizer, Novartis, Lilly, Daiichi Sankyo, Myriad, MSD.

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Udovica, S., Strasser-Weippl, K. Neoadjuvant and adjuvant therapy in early breast cancer. A short review on current clinical approaches. memo 16, 125–128 (2023). https://doi.org/10.1007/s12254-023-00888-z

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