Response to neoadjuvant chemo for breast cancer varies by sex

Both proportions and odds of pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) are numerically lower in men with breast cancer (BC) versus women with BC for each tumor subtype, according to a study published online Sept. 7 in Cancer.

José Pablo Leone, M.D., from the Dana-Farber Cancer Institute in Boston, and colleagues compared the proportions of pCR between men and women with BC by tumor subtype. The analysis included 385 men and 68,065 women with BC who were treated with NAC in 2010 through 2016.

The researchers found that the proportions of pCR in men with BC and women with BC by tumor subtype were: hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−): 4.9 versus 9.7 percent; HR+/HER2+: 16.1 versus 33.6 percent; HR−/HER2+: 44.0 versus 53.2 percent (statistically nonsignificant difference); and HR−/HER2−: 21.4 versus 32.1 percent (statistically nonsignificant difference), respectively. Women had twice the odds of pCR than men with BC (adjusted odds ratio, 2.0). For men with versus without pCR, five-year overall survival was 90 percent versus 64.7 percent, and for women with versus without pCR, five-year overall survival was 91.9 percent versus 75.3 percent, respectively.

"The results from our study are valuable to inform about the comparative efficacy of NAC between men and women with breast cancer, given that there has never been a prospective trial evaluating the efficacy of NAC in males with BC, and there are no prospective comparisons of the efficacy of NAC between sexes," the authors write.

Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.

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