To the Editor One of the advantages of neoadjuvant therapy (NAT) is assessment of tumor response to specific drugs in vivo, so NAT can serve as a brilliant research platform to evaluate novel therapies. For neoadjuvant clinical trials, tumor response, as a surrogate end point, should be strongly associated with long-term outcome to provide important prognosis information and guide postoperative adjuvant treatment. In their recent analysis of a randomized clinical trial in JAMA Oncology, Symmans et al1 demonstrated that residual cancer burden (RCB) was associated with event-free survival regardless of subtype and treatment, and they suggested that the shift of RCB distributions may imply treatment efficacy for survival benefit. Though the study provides promising results for using a quantitative method to assess tumor response and treatment efficacy in neoadjuvant trials of breast cancer, there are 2 points that we would like to discuss.
Huang X, Liu Z. Association of Residual Cancer Burden After Neoadjuvant Therapy and Event-Free Survival in Breast Cancer. JAMA Oncol. 2022;8(4):645. doi:10.1001/jamaoncol.2021.7997
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