RT Book, Section
A1 Symmans, W. Fraser
A2 Kuerer, Henry M.
SR Print(0)
ID 6410078
T1 Chapter 25. Pathology Post-Neoadjuvant Therapy
T2 Kuerer's Breast Surgical Oncology
YR 2010
FD 2010
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-160178-8
LK accesssurgery.mhmedical.com/content.aspx?aid=6410078
RD 2024/04/25
AB A  central  tenet  of  neoadjuvant  clinical  trials  is  that  tumor  response,  as  a  surrogate  end  point,  should  be  strongly  correlated  with  long-term  patient  survival.1,2  Otherwise,  the  value  of  neoadjuvant  treatment  would  be  to  convert  a  tumor  to  operability  or  to  increase  the  probability  of  conservative  surgery.  However,  a  close  association  between  pathologic  response  to  treatment  and  subsequent  survival  establishes  neoadjuvant  treatment  as  a  method  for  clinical  trials  including  operable  disease  to  evaluate  promising  treatments  more  purely  in  terms  of  direct  tumoricidal  activity  and  without  confounding  variables  of  natural  history  and  subsequent  treatments.  Indeed,  pathologic  complete  response  (pCR)  has  been  adopted  as  the  primary  end  point  for  neoadjuvant  trials  because  it  has  consistently  been  associated  with  long-term  survival  in  neoadjuvant  trials  using  different  chemotherapy  regimens  of  variable  treatment  duration.3-12  If  pCR  is  achieved  using  current  therapies,  one  can  anticipate  more  than  90%  probability  of  disease-free  survival  within  the  first  decade  of  follow-up.