Neoadjuvant and adjuvant therapy in early breast cancer. A short review on current clinical approaches

Early breast cancer (eBC) is a potentially curable disease. Its treatment is multimodal and includes surgery, radiotherapy and systemic therapy in either the neoadjuvant or the adjuvant setting. The treatment of eBC is an evolving field with a wealth of algorithms available, focusing on avoiding both over- and undertreatment. Molecular subtypes, genetic profiling, locoregional tumor load, patient age, comorbidities and the patient’s preferences all need to be taken into account when treating eBC. Recently, novel therapeutic options, including immune checkpoint inhibitors, cyclin-dependent kinase 4/6 (CDK4/6), and poly(ADP ribose)polymerase (PARP) inhibitors, have been approved in eBC. Besides these options for high-risk eBC, efforts have been made to de-escalate the use of cytotoxic chemotherapy, especially in hormone receptor-positive (HR+) eBC and HER2-positive (HER2+) eBC. This article summarizes recent developments in the systemic treatment of eBC.