Do the results of the GEPAR trials indicate that PMRT based on pre-neoadjuvant chemo risk factors, irrelevant of pCR, should be the standard of care until NSABP B-51 is completed?
The GEPAR trials presented at ASCO 2015 showed increased LRR with the omission of RT in patients who had a pCR after neoadjuvant chemotherapy.
Answer from: Radiation Oncologist at Academic Institution
I do not think the GEPAR ASCO 2015 abstract and presentation should be used to conclude that we should recommend PMRT for all node + positive patients regardless of response to preoperative treatment.There are several reasons for this:*This is an unplanned analysis of the studies, in which radiation...
Answer from: Radiation Oncologist at Community Practice
Looking at the GEPAR results, in the mastectomy group about 29 patients had pCR and no RT, and in that group RT didn't make any difference in locoregional relapse free survival. What was interesting was that patients with clinical N-positive disease who converted to ypN0 (about 40 pts in the no RT a...
Answer from: Radiation Oncologist at Academic Institution
The German Breast Group has performed a number of large trials comparing different regimens of neoadjuvant chemotherapy (NACT). They presented results from these regarding local-regional recurrence (LRR) in San Antonio in 2015. However, they did not publish these data from the three “GEPAR&rdq...
Comments
Radiation Oncologist at Varian Medical Systems/Allegheny health network More recent Dutch data (Lancet 2022) with tailored...