title: Neoadjuvant hormonal therapy for endocrine sensitive breast cancer: a systematic review.
abstract: In recent years, studies investigating neoadjuvant therapies have been emerging, because of the additional benefits it provides in terms of facilitating less extensive surgery and the possibility of investigating tumor biological features and response. Neoadjuvant hormonal therapy (NHT) is, in general, considered to be a suitable option for hormone receptor (HR)-positive patients who are unfit for chemotherapy or surgery, and is increasingly being utilized to achieve tumor downsizing before surgery in postmenopausal women. Studies investigating NHT were reviewed for tumor response data. NHT demonstrated similar efficacy to neoadjuvant chemotherapy (NCT) in HR-positive breast cancer patients. Clinical responses ranged from 13.5% to 100%, with treatment periods between 3 and 24 months. In studies comparing tamoxifen with aromatase inhibitors, the latter were superior in terms of tumor response and rates of breast-conserving surgery (BCS). In most studies with treatment durations longer than 3 months, tumor response rates increased. Therefore, longer durations of NHT are feasible and should be considered as an alternative to NCT in selected patients.
authors.affiliation: Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Charehbili
authors.forename: D B Y
authors.initials: DB
authors.lastname: Fontein
authors.forename: J R
authors.initials: JR
authors.lastname: Kroep
authors.forename: G J
authors.initials: GJ
authors.lastname: Liefers
authors.forename: J S D
authors.initials: JS
authors.lastname: Mieog
authors.forename: J W R
authors.initials: JW
authors.lastname: Nortier
authors.forename: C J H
authors.initials: CJ
authors.lastname: van de Velde
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000378:metabolism; D016032:Randomized Controlled Trials as Topic; D011956:Receptors, Cell Surface / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D011956:Receptors, Cell Surface
keywords: Breast cancer; Elderly; Endocrine therapy; Neoadjuvant; Surgery