| Added by | pcoopman |
|---|---|
| Group name | EquipePC |
| Item Type | Journal Article |
| Title | Survival outcomes after neoadjuvant letrozole and palbociclib versus third generation chemotherapy for patients with high-risk oestrogen receptor-positive HER2-negative breast cancer |
| Creator | Delaloge et al. |
| Author | Suzette Delaloge |
| Author | Sylvain Dureau |
| Author | Véronique D'Hondt |
| Author | Isabelle Desmoulins |
| Author | Pierre-Etienne Heudel |
| Author | Francois P. Duhoux |
| Author | Christelle Levy |
| Author | Florence Lerebours |
| Author | Marie A. Mouret-Reynier |
| Author | Florence Dalenc |
| Author | Jean-Sébastien Frenel |
| Author | Christelle Jouannaud |
| Author | Laurence Venat-Bouvet |
| Author | Suzanne Nguyen |
| Author | Cécile Callens |
| Author | David Gentien |
| Author | Audrey Rapinat |
| Author | Helene Manduzio |
| Author | Anne Vincent-Salomon |
| Author | Jérôme Lemonnier |
| Author | Paul Cottu |
| Abstract | BACKGROUND: Besides their development as additional adjuvant treatments, CDK4/6 inhibitors combined with endocrine therapy could represent less toxic alternatives to chemotherapy in postmenopausal women with high-risk oestrogen receptor-positive, HER2-negative breast cancer currently a candidate for chemotherapy. The multicentre, international, randomised phase 2 NEOPAL trial showed that the letrozole-palbociclib combination led to clinical and pathological responses equivalent to sequential anthracycline-taxanes chemotherapy. Secondary objectives included survival outcomes. METHODS: Secondary end-points of NEOPAL included progression-free survival (PFS) and invasive-disease free survival (iDFS) in the intent-to-treat population. Exploratory end-points were overall survival (OS) and breast cancer specific survival (BCSS) in the intent-to-treat population, as well as iDFS, OS and BCSS according to the administration of chemotherapy. RESULTS: Hundred and six patients were randomised. Pathological complete response rates were 3.8% and 5.9%. Twenty-three of the 53 patients in the letrozole-palbociclib arm received postoperative adjuvant chemotherapy. At a median follow-up of 40.4 months [0-56.6], 11 progressions have been observed, of which three were in the letrozole-palbociclib and 8 in the control arm. PFS (HR = 1.01; [95%CI 0.36-2.90], p = 0.98) and iDFS (HR = 0.83; [95%CI 0.31-2.23], p = 0.71) did not differ between both arms. The 40 months PFS rate was 86.7% [95%CI 78.0-96.4] and 89.9% [95%CI 81.8-98.7] in letrozole-palbociclib and control arms, respectively. Outcomes of patients who did not receive chemotherapy were not statistically different from those who received it. CONCLUSIONS: NEOPAL suggests that a neoadjuvant letrozole-palbociclib strategy may allow sparing chemotherapy in some patients with luminal breast cancer while allowing good long-term outcomes. Larger confirmatory studies are needed. |
| Publication | European Journal of Cancer (Oxford, England: 1990) |
| Volume | 166 |
| Pages | 300-308 |
| Date | 2022-05 |
| Journal Abbr | Eur J Cancer |
| Language | eng |
| DOI | 10.1016/j.ejca.2022.01.014 |
| ISSN | 1879-0852 |
| Library Catalog | PubMed |
| Extra | PMID: 35337692 |
| Tags | Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, CDK4/6 inhibitor, Chemotherapy, clinic, Female, Humans, Luminal breast cancer, Neoadjuvant Therapy, Piperazines, Pyridines, Receptor, ErbB-2, Receptors, Estrogen, Survival, Survival Analysis |
| Date Added | 2023/11/20 - 17:09:35 |
| Date Modified | 2023/11/20 - 17:12:30 |
| Notes and Attachments | PubMed entry (Attachment) |
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