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 2024/11/06 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.