(Neo-)adjuvant chemotherapy in breast cancer – Trials, errors and new rationales from the SABCS 2007
During the San Antonio Breast Cancer Symposium 2007 some of the large prospective randomized trials reported failed to show clear-cut advantages of chemotherapeutic regimens that are considered to be more aggressive than standard therapy. Molecular profiles of breast cancer have allowed us to create standardized tools that make response prediction in several patient subsets possible. Although none of the new technology can be recommended for daily clinical practice, future trial design should implement some of the newly gained rationales at its best. Furthermore, tissue collection during the production of clinical trials should be considered mandatory in order to carry out translational research. Clearly, breast cancer research has moved from an era focusing on a treatment stratification largely determined by risk to an acknowledgement of disease heterogeneity requiring a prediction of response before therapy is assigned.