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Table 3 Duration of neoadjuvant endocrine therapy

From: Neoadjuvant endocrine therapy in locally advanced estrogen or progesterone receptor-positive breast cancer: determining the optimal endocrine agent and treatment duration in postmenopausal women—a literature review and proposed guidelines

Study Duration (months) Dose (mg/day) No. of patients Study outcomes Assessment
Rusz et al. 2015 [29] 12 Letrozole 2.5 42 1. pCR: 14.3% operated cases; 13% overall
2. ORR (clinical palpation): 88%
3. BCS: 45%
Clinical palpation every 3 months. Imaging as necessary.
Carpenter et al. 2014 [30] Up to 12 Letrozole 2.5 139 1. pCR: not reported.
2. ORR (clinical palpation): 85% (3.2% CR and 81.5% PR)
3. BCS: 66% at 12 months (all ineligible at baseline)
Clinical examination and bimodal ultrasound every 2 months until BCS.
Allevi et al. 2013 [27] Randomized to 4, 8, or 12 Letrozole 2.5 120 1. pCR: 2.5% 4 months; 5% 8 months and 17.5% 12 months.
2. ORR (clinical palpation): 45% 4 months; 86.8% 8 months; 95% 12 months.
3. BCS: 80% 4 months; 85% 8 months; 87.5% 12 months.
Monthly clinical palpation (caliper). Mammography and ultrasound at baseline and before surgery.
Llombart-Cussac et al. 2012 [73] 3 to 12 Letrozole 2.5 70 1. pCR: 0%
2. ORR (clinical palpation): 76.8% (25% CR and 51.8% PR)
3. BCS: 43%
Monthly clinical examination. Mammogram and ultrasound every 8 weeks for first 4 months.
Dixon et al. 2009 [71] 3 to > 24 months Letrozole 2.5 182 1. pCR: NR.
2. ORR (clinical palpation): 69.8% 3 months; 83.5% > 3 months.
3. BCS: 60% 3 months; 72% > 3 months.
Clinical measurement and ultrasound at 0, 2, 6, and 12 weeks. Mammogram at 0 and 12 weeks. 3 monthly review thereafter.
Krainick-Strobel et al. 2008 [72] 4 to 8 Letrozole 2.5 32 1. pCR: NR.
2. ORR (clinical palpation): 55% 4 months; 72.4% 8 months.
3. BCS: 75.9% (all ineligible at baseline)
Monthly clinical examination, ultrasound and mammogram.
TEAM IIA Fontein et al. 2014 [70] 3 to 6 Exemestane 25 102 1. pCR: 0.98%
2. ORR (clinical palpation): 58.7% 3 months; 68.3% > 3 months (p = 0.031).
3. BCS: feasibility improved 61.8% to 70.6%.
Monthly clinical palpation.
3 monthly MRI, mammogram or ultrasound.
PTEX46 Hojo et al. 2013 [76] 4 or 6 Exemestane 25 52 1. pCR: 0% 4 months; 4% 6 months.
2. ORR (clinical palpation): 42.3% 4 months; 48% 6 months (p = 0.89).
3. BCS: 50% 4 months; 48% 6 months.
Monthly caliper measurement and toxicity assessment. Ultrasound and mammogram if progression suspected.
  1. BCS breast-conserving surgery, pCR pathological complete response, ORR objective response rate, CR complete response, PR partial response, NR not reported. See Additional file 1, Table S2 for definitions