The role of neoadjuvant trials in drug development for solid tumors Journal Article


Authors: Funt, S. A.; Chapman, P. B.
Article Title: The role of neoadjuvant trials in drug development for solid tumors
Abstract: The relatively low success rate of phase II oncology trials in predicting success of novel drugs in phase III trials and in gaining regulatory approval may be due to reliance on the endpoint of response rate defined by the RECIST. The neoadjuvant treatment paradigm allows the antitumor activity of a novel therapy to be determined on a pathologic basis at the time of surgery instead of by RECIST, which was not developed to guide clinical decision making or correlate with long-term outcomes. Indeed, the FDA endorsed pathologic complete response (pCR) as a surrogate for overall survival (OS) in early-stage breast cancer and granted accelerated approval to pertuzumab based on this endpoint. We propose that pCR is a biologically rational method of determining treatment effect that may be more likely to predict OS. We discuss some advantages of the neoadjuvant trial design, review the use of neoadjuvant therapy as standards of care, and consider the neoadjuvant platform as a method for drug development. © 2016 American Association for Cancer Research.
Journal Title: Clinical Cancer Research
Volume: 22
Issue: 10
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2016-05-15
Start Page: 2323
End Page: 2328
Language: English
DOI: 10.1158/1078-0432.ccr-15-1961
PROVIDER: scopus
PUBMED: 26842238
PMCID: PMC5502354
DOI/URL:
Notes: Review -- Export Date: 1 July 2016 -- Source: Scopus
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  1. Paul Chapman
    326 Chapman
  2. Samuel Aaron Funt
    135 Funt