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Front Oncol: Efficacy of neoadjuvant chemotherapy (NCT) versus neoadjuvant endocrine therapy (NET) for premenopausal breast cancer patients with ER+/HER2- and lymph node positive: Phase III clinical study NEST

 Last Update: 2021-10-10
 Source: Internet
 Author: User

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In the postoperative management of breast cancer patients , lymphedema is the surgical complication that surgeons are most likely to encounter and try to avoid .
In patients undergoing neoadjuvant systemic therapy (NST), treatment decisions for axillary lymph nodes have become increasingly complex .
For breast cancer patients with ER+/HER2- and lymph node positive, the best strategy for neoadjuvant therapy still needs to be actively explored .
Therefore, a team from South Korea conducted a clinical study of NEST (NCT01622361) to evaluate the efficacy of neoadjuvant chemotherapy (NCT) versus neoadjuvant endocrine therapy (NET) in ER+/HER2- and lymph node-positive premenopausal breast cancer patients .
The results were published in Frontiers in Oncology .

In the postoperative management of breast cancer patients , lymphedema is the surgical complication that surgeons are most likely to encounter and try to avoid .

In patients receiving neoadjuvant systemic therapy (NST), treatment decisions for axillary lymph nodes have become increasingly complex .
For breast cancer patients with ER+/HER2- and lymph node positive, the best strategy for neoadjuvant therapy still needs to be actively explored .
Therefore, a team from South Korea conducted a clinical study of NEST (NCT01622361) to evaluate the efficacy of neoadjuvant chemotherapy (NCT) versus neoadjuvant endocrine therapy (NET) in ER+/HER2- and lymph node-positive premenopausal breast cancer patients .
The results were published in Frontiers in Oncology .
Breast cancer management

NEST is a prospective, multi-center, randomized, parallel controlled phase III clinical trial that mainly evaluates the axillary lymph node clearance (ALND), axillary recurrence-free survival (ARFS), disease-free survival (DFS) and overall survival of the two groups Period (OS)
.

Finally, 174 patients were enrolled, including 87 cases of neoadjuvant chemotherapy (NCT) and neoadjuvant endocrine therapy (NET)
.

All patients completed 24 weeks of neoadjuvant therapy

Finally, 174 patients were enrolled, including 87 cases of neoadjuvant chemotherapy (NCT) and neoadjuvant endocrine therapy (NET)

The median age is 42 years (range 27 to 54 years)

Clinical features

49.
4% of NCT patients and 55.
4% of NET patients underwent mastectomy after treatment, and the difference was not statistically significant (p = 0.
447)
.

7 cases (8.

49.

Efficacy evaluation

During a median follow-up of 67.
3 months, 19 patients in the NCT group had recurrence and metastasis (local, n=3; axillary, n = 3; internal breast LN recurrence, n=1; distant metastasis, n = 12); NET Group 12 cases of metastasis (all distant metastases, n=12)
.

5-year ARFS (97.

During a median follow-up of 67.

ARFS

DFS

In summary, studies have shown that although neoadjuvant chemotherapy (NCT) and neoadjuvant endocrine therapy (NET) have no difference in the prognosis of patients, NCT treatment may avoid more lymph node resections and fewer lymph nodes
.

Studies have shown that although neoadjuvant chemotherapy (NCT) and neoadjuvant endocrine therapy (NET) have no difference in the prognosis of patients, NCT treatment may avoid more lymph node removal and fewer lymph nodes

Original source:

Gwark S, Noh WC, Ahn SH, Lee ES, Jung Y, Kim LS, Han W, Nam SJ, Gong G, Kim SO and Kim HJ (2021) Axillary Lymph Node Dissection Rates and Prognosis From Phase III Neoadjuvant Systemic Trial Comparing Neoadjuvant Chemotherapy With Neoadjuvant Endocrine Therapy in Pre-Menopausal Patients With Estrogen Receptor-Positive and HER2-Negative, Lymph Node-Positive Breast Cancer.

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