Neoadjuvant trial design: time for a brave new world?

Heather McArther and Clifford Hudis

In the NOAH clinical trial, trastuzumab treatment for locally advanced breast cancer, given prior to surgery, was associated with increased complete and overall response rate and improved event free survival.The ability to identify this advantage suggests that the neoadjuvant setting might serve to inform the design of adjuvant trials and indicate appropriate off-study adjuvant therapy.

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