Effects of neoadjuvant chemotherapy with or without XXXX on pathological response: A meta-analysis of randomised trials.

@entity0 @entity1 @entity4381 @entity171
PURPOSE: The addition of @entity171 to adjuvant therapy improves survival in postmenopausal @entity0 ( @entity0 ) @entity1 . We report a meta-analysis of four randomised trials of neoadjuvant chemotherapy (CT) +/- @entity4381 (ZA) in stage II/III @entity0 to investigate the potential for enhancing the pathological response. METHODS: Individual @entity1 data from four prospective randomised clinical trials reporting the effect of the addition of ZA on the pathological response after neoadjuvant CT were pooled. Primary outcomes were pathological complete response in the breast (pCRb) and in the breast and lymph nodes (pCR). Trial-level and individual @entity1 data meta-analyses were done. Predefined subgroup-analyses were performed for postmenopausal @entity1 and @entity1 with triple-negative  @entity0 . RESULTS: pCRb and pCR data were available in 735 and 552 @entity1 respectively. In the total study population ZA addition to neoadjuvant CT did not increase pCRb or pCR rates. However, in postmenopausal @entity1 , the addition of ZA resulted in a significant, near doubling of the pCRb rate (10.8% for CT only versus 17.7% with CT+ZA; odds ratio [OR] 2.14, 95% confidence interval [CI] 1.01-4.55) and a non-significant benefit of the pCR rate (7.8% for CT only versus 14.6% with CT+ZA; OR 2.62, 95% CI  0.90-7.62). In @entity1 with triple-negative @entity0 a trend was observed favouring CT+ZA. CONCLUSION: This meta-analysis shows no impact from the addition of ZA to neoadjuvant CT on pCR. However, as has been seen in the adjuvant setting, the addition of ZA to neoadjuvant CT may augment the effects of CT in postmenopausal @entity1 with @entity0 .
