Neoadjuvant endocrine treatment for breast cancer: from bedside to bench and back again?

  • R.R. Saleh McGill University Health Centre
  • N. Bouganim McGill University Health Centre
  • J. Hilton Dana–Farber Cancer Institute
  • A. Arnaout The Ottawa Hospital Cancer Centre, University of Ottawa
  • M. Clemons The Ottawa Hospital Cancer Centre, University of Ottawa
Keywords: Medical oncology, breast cancer, neoadjuvant therapy, endocrine therapy

Abstract

In recent years, considerable attention has been paid to the role of neoadjuvant chemotherapy as a pluripotential test bed for the treatment of breast cancer. Although traditionally reserved to render inoperable disease operable, neoadjuvant chemotherapy is increasingly being used to improve the chance for breast-conserving surgery, to gain information on pathologic response rates for a more rapid assessment of new chemotherapy–biologic regimens, and also to study in vivo tumour sensitivity or resistance to the agent being used. Similarly, use of neoadjuvant endocrine treatment was also traditionally restricted to elderly or frail patients who were felt to be unsuitable for chemotherapy. It is therefore not surprising that, given the increasing realization of the pivotal role of endocrine therapy in patient care, there is enhanced interest in neoadjuvant endocrine therapy not only as a less-toxic alternative to chemotherapy, but also to assess tumour sensitivity or resistance to endocrine agents. The availability of newer endocrine manipulations and increasing evidence that the benefits of chemotherapy are frequently marginal in many hormone-positive patients is making endocrine therapy increasingly important in the clinical setting. The hope is that, one day, instead of preoperative endocrine therapy being restricted to the infirm and the elderly, it will be used in the time between biopsy diagnosis and surgery to predict which patients will or will not benefit from chemotherapy in the adjuvant setting.

Author Biographies

R.R. Saleh, McGill University Health Centre
Division of Medical Oncology
N. Bouganim, McGill University Health Centre

Assistant Professor, Division of Medical Oncology

J. Hilton, Dana–Farber Cancer Institute
Medical Oncologist, Division of Medical Oncology
A. Arnaout, The Ottawa Hospital Cancer Centre, University of Ottawa
Assistant Professor, Department of Surgery
M. Clemons, The Ottawa Hospital Cancer Centre, University of Ottawa
Division of Medical Oncology, Associate Professor, Department of Medicine
Published
2013-11-07
How to Cite
Saleh, R., Bouganim, N., Hilton, J., Arnaout, A., & Clemons, M. (2013). Neoadjuvant endocrine treatment for breast cancer: from bedside to bench and back again?. Current Oncology, 21(1), e122-e128. https://doi.org/10.3747/co.21.1627
Section
Review Article