DR SLEDGE: Luca Gianni and his group in Italy looked at this several years ago in terms of who benefits from neoadjuvant chemotherapy. And it’s pretty clear that the population that benefits is the population that has the high proliferation cassette. So certainly something like either the 21- or the 70-gene assay would be likely to pick that up.

I think of other cases that are similar. So, for instance, I’ve not infrequently seen patients with invasive lobular carcinomas where you see the diffusely infiltrative stuff throughout the breast and where we know that the pathologic complete response rate is in the low single digits for these patients and where there’s a little bit of data that says the only people who benefit from chemotherapy are those who have a really high proliferation index in that setting.

So whenever I have a patient with a lobular carcinoma of the breast, I have real serious doubts as to whether or not I’m giving them any benefit with chemotherapy. And it’s certainly a population where I would think about giving neoadjuvant hormonal therapy.

Early-stage breast cancer (BC) in the adjuvant and neoadjuvant settings

Genomic assays and (neo)adjuvant treatment decision-making

Management of metastatic BC (mBC)

CDK4/6 inhibitors for the treatment of BC

Novel approaches under investigation in BC