Circulating Tumor Cells in Patients Receiving Neoadjuvant Chemotherapy: Refining the Paradigm of Prognosis and Treatment Individualization

Neoadjuvant chemotherapy (NAC) was originally reserved for patients with locally advanced breast cancer who required tumor downstaging in order to achieve resectability, but its use eventually expanded to include those with large, operable disease (1). NAC offers several clinical advantages relative to the loco-regional management of the disease, and by observing tumor response to NAC, valuable insight can be obtained into a patient's tumor biology (1). Achievement of pathologic complete response (pCR) in the breast and axilla with NAC strongly correlates with excellent long-term outcomes (2,3), making pCR a short-term surrogate end point for chemotherapy efficacy (4). The strong correlation between pCR and improved outcomes implies that if NAC eliminates all invasive cancer cells from the breast and axilla, it likely eliminates micrometastatic disease sites or disseminated tumor cells.

https://ift.tt/2JD9ZaE