- Neoadjuvant chemotherapy (NACT) is associated with poorer OS than ACT, but with no difference in disease-free survival (DFS) in triple-negative breast cancer (TNBC).
- However, the results for subgroups in this meta-analysis are conflicting.
Why this matters
- Findings cast doubt on NACT, which has become the standard treatment for TNBC.
- The results suggest that NACT could be adopted for patients with pathologic complete response (pCR), but not those with residual disease.
- Meta-analysis by Chinese researchers of 9 retrospective and prospective studies involving 36,480 patients.
- Funding: None.
- Across all patients, NACT vs ACT was associated with worse OS (HR, 1.59; P=.0001), but with no difference between groups for DFS (HR, 0.85; P=.49).
- In the subgroup of patients achieving pCR, NACT (vs ACT) was superior for OS (HR, 0.53; P=.04) and DFS (HR, 0.52; P=.03).
- In the subgroup of patients with residual disease, NACT (vs ACT) was associated with worse OS (HR, 1.18; P<.0001 and dfs p=".0008).</li">
- Publication bias.
- Most studies (7/9) were retrospective.