Evolving Role of Neoadjuvant Endocrine Therapy in Hormone Receptor Positive Breast Cancer: a Review

Douglas SR, Thomas SM, van den Bruele AB, et al. Neoadjuvant Endocrine Therapy Use in Estrogen Receptor Positive Breast Cancer: Insights from Practice Shifts During the COVID-19 Pandemic. Ann Surg Oncol. 2026;33(1):86–94. https://doi.org/10.1245/s10434-025-18307-4.

Article  PubMed  Google Scholar 

van de Loo ME, Andour L, van Heesewijk AE, Oosterkamp HM, Liefers GJ, Straver ME. Neoadjuvant endocrine treatment in hormone receptor-positive breast cancer: Does it result in more breast-conserving surgery? Breast Cancer Res Treat. 2024;205(1):5–16. https://doi.org/10.1007/s10549-023-07222-5.

Article  CAS  PubMed  Google Scholar 

Cao L, Sugumar K, Keller E, et al. Neoadjuvant Endocrine Therapy as an Alternative to Neoadjuvant Chemotherapy Among Hormone Receptor-Positive Breast Cancer Patients: Pathologic and Surgical Outcomes. Ann Surg Oncol. 2021;28(10):5730–41. https://doi.org/10.1245/s10434-021-10459-3.

Article  PubMed  PubMed Central  Google Scholar 

Leonard L, Yi M, Wingate E, et al. Axillary Management after Neoadjuvant Endocrine Therapy (NET). Ann Surg Oncol. 2026;33(4):3327–37. https://doi.org/10.1245/s10434-025-18916-z.

Article  PubMed  Google Scholar 

An SJ, Thai CHNC, Ismail S, et al. Nodal Response and Survival After Neoadjuvant Endocrine Therapy in Hormone Receptor-Positive Breast Cancer: 20-Year Experience from a Single Institution. Ann Surg Oncol. 2024;31(13):8786–94. https://doi.org/10.1245/s10434-024-16059-1.

Article  PubMed  Google Scholar 

Martínez-Pérez C, Turnbull AK, Kay C, Dixon JM. Neoadjuvant endocrine therapy in postmenopausal women with HR+/HER2- breast cancer. Expert Rev Anticancer Ther. 2023;23(1):67–86. https://doi.org/10.1080/14737140.2023.2162043.

Article  CAS  PubMed  Google Scholar 

Miligy IM, Awasthi R, Mir Y, et al. Morphological and molecular changes of oestrogen receptor-positive breast cancer following bridging endocrine therapy: a United Kingdom multicentre study. Histopathology. 2024;85(3):405–17. https://doi.org/10.1111/his.15238.

Article  PubMed  Google Scholar 

Dave RV, Elsberger B, Taxiarchi VP, et al. Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study. Breast Cancer Res Treat. 2023;199(2):265–79. https://doi.org/10.1007/s10549-023-06893-4.

Article  PubMed  PubMed Central  Google Scholar 

Bergamino MA, Morani G, Parker J, et al. Impact of Duration of Neoadjuvant Aromatase Inhibitors on Molecular Expression Profiles in Estrogen Receptor-positive Breast Cancers. Clin Cancer Res. 2022;28(6):1217–28. https://doi.org/10.1158/1078-0432.CCR-21-2718.

Article  CAS  PubMed  Google Scholar 

Madigan LI, Dinh P, Graham JD. Neoadjuvant endocrine therapy in locally advanced estrogen or progesterone receptor-positive breast cancer: determining the optimal endocrine agent and treatment duration in postmenopausal women-a literature review and proposed guidelines. Breast Cancer Res. 2020;22(1):77. https://doi.org/10.1186/s13058-020-01314-6. Published 2020 Jul 20.

Article  PubMed  PubMed Central  Google Scholar 

Jones V, Schroeder MC, Roberson ML, De Andrade J, Lizarraga IM. Differential response to neoadjuvant endocrine therapy for Black/African American and White women in NCDB. Breast Cancer Res Treat. 2024;203(1):125–34. https://doi.org/10.1007/s10549-023-07106-8.

Article  CAS  PubMed  Google Scholar 

Wu P, Lv W. Concurrent neoadjuvant endocrine therapy with chemotherapy in HR+HER2- breast cancer: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2024;15:1254213. https://doi.org/10.3389/fendo.2024.1254213. Published 2024 Feb 28.

Article  PubMed  PubMed Central  Google Scholar 

Ma HF, Shen J, Xu B, Shen JG. Neoadjuvant chemotherapy combined with endocrine therapy for hormone receptor-positive breast cancer: A systematic review and meta-analysis. Med (Baltim). 2023;102(46):e35928. https://doi.org/10.1097/MD.0000000000035928.

Article  CAS  Google Scholar 

Chae H, Sim SH, Kwon Y et al. Neoadjuvant chemotherapy with concurrent letrozole for estrogen receptor-positive and HER2-negative breast cancer: an open-label, single-center, nonrandomized phase II study (NeoCHAI). Cancers (Basel). 2024;16(18):3122. https://doi.org/10.3390/cancers16183122. Published 2024 Sep 10.

Zhang M, Li M, Zhou S, et al. Efficacy of neoadjuvant endocrine therapy with CDK4/6 inhibitors in locally advanced breast cancer. Oncologist. 2026;31(3):oyag032. https://doi.org/10.1093/oncolo/oyag032.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ueno T, Chow LWC, Han W, et al. Neoadjuvant palbociclib in women with operable, hormone receptor-positive breast cancer. Endocr Relat Cancer. 2025;32(9):e240353. https://doi.org/10.1530/ERC-24-0353. Published 2025 Sep 11.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kong T, Mabry A, Highkin M et al. Biomarkers of response to neoadjuvant palbociclib plus anastrozole in endocrine-resistant estrogen receptor-positive/HER2-negative breast cancer: a phase 2 trial. Nat Commun. 2026;17(1):949. https://doi.org/10.1038/s41467-026-68570-6. Published 2026 Jan 27.

Fullana B, Morales S, Petit A, et al. Neoadjuvant sunitinib plus exemestane in post-menopausal women with hormone receptor-positive/HER2-negative early-stage breast cancer (SUT_EXE-08): a phase I/II trial. Sci Rep. 2024;14(1):23626. https://doi.org/10.1038/s41598-024-72152-1. Published 2024 Oct 9.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Li X, Du P, Huang T. Beyond Chemotherapy: Network Meta-Analysis Reveals Optimal Neoadjuvant Strategies for Luminal Breast Cancer. Cancer Med. 2026;15(2):e71648. https://doi.org/10.1002/cam4.71648.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Soyano Muller AE, Goodridge DN, Mo Q et al. Neoadjuvant therapy with an aromatase inhibitor and durvalumab in postmenopausal patients with hormone receptor-positive breast cancer. Breast Cancer Res Treat. 2026;216(1):11. https://doi.org/10.1007/s10549-026-07912-w. Published 2026 Feb 16.

Engebrethsen C, Yndestad S, Rasmussen ME, et al. Neoadjuvant endocrine therapy with sequential palbociclib and chemotherapy based on Ki67 status in stage II-III breast cancer: An open-label, phase II study. Breast. 2026;85:104672. https://doi.org/10.1016/j.breast.2025.104672.

Article  PubMed  Google Scholar 

Lightowlers SV, Machin A, Woitek R, et al. Neoadjuvant Radiotherapy and Endocrine Therapy for Oestrogen Receptor Positive Breast Cancers: The Neo-RT Feasibility Study. Clin Oncol (R Coll Radiol). 2025;37:103669. https://doi.org/10.1016/j.clon.2024.103669.

Article  CAS  PubMed  Google Scholar 

Harbeck N, Nitz UA, Christgen M, et al. De-Escalated Neoadjuvant Trastuzumab-Emtansine With or Without Endocrine Therapy Versus Trastuzumab With Endocrine Therapy in HR+/HER2 + Early Breast Cancer: 5-Year Survival in the WSG-ADAPT-TP Trial. J Clin Oncol. 2023;41(22):3796–804. https://doi.org/10.1200/JCO.22.01816.

Article  CAS  PubMed  Google Scholar 

Liu S, Yu M, Mou E et al. The optimal neoadjuvant treatment strategy for HR+/HER2 + breast cancer: a network meta-analysis. Sci Rep. 2025;15(1):713. https://doi.org/10.1038/s41598-024-84039-2. Published 2025 Jan 3.

Montagna G, Sevilimedu V, Fornier M, Jhaveri K, Morrow M, Pilewskie ML. How Effective is Neoadjuvant Endocrine Therapy (NET) in Downstaging the Axilla and Achieving Breast-Conserving Surgery? Ann Surg Oncol. 2020;27(12):4702–10. https://doi.org/10.1245/s10434-020-08888-7.

Article  PubMed  PubMed Central  Google Scholar 

Andour L, Kroep JR, Putter H, Tollenaar RAEM, Mesker WE, Straver ME. Neoadjuvant endocrine therapy often leads to breast and axilla-conserving surgery in stages II and III hormone receptor-positive breast cancer patients: A registry study. Int J Cancer. 2026;158(7):1905–15. https://doi.org/10.1002/ijc.70219.

Article  CAS  PubMed  Google Scholar 

van Olmen JP, Jacobs CF, Bartels SAL, et al. Radiological, pathological and surgical outcomes after neoadjuvant endocrine treatment in patients with ER-positive/HER2-negative breast cancer with a clinical high risk and a low-risk 70-gene signature. Breast. 2024;75:103726. https://doi.org/10.1016/j.breast.2024.103726.

Article  PubMed  PubMed Central  Google Scholar 

Douglas SR, Thomas SM, Chiba A, et al. Contemporary Trends in Axillary Surgery for ER-Positive, HER2-Negative Breast Cancer Stratified by Neoadjuvant Endocrine Therapy, Neoadjuvant Chemotherapy, or Upfront Surgery. Ann Surg Oncol. 2026;33(1):95–107. https://doi.org/10.1245/s10434-025-18225-5.

Article  PubMed  Google Scholar 

Vasigh M, Karoobi M, Williams AD, et al. Neoadjuvant Endocrine Therapy Compared to Neoadjuvant Chemotherapy in Node-Positive HR+, HER2- Breast Cancer (Nodal pCR and the Rate of ALND): A Systematic Review and Meta-Analysis. Breast J. 2024;2024:8866756. https://doi.org/10.1155/2024/8866756. Published 2024 Aug 2.

Article  PubMed  PubMed Central  Google Scholar 

Weiss A, Revette A, Nava-Coulter B, Mittendorf EA, Filho OM, King TA. Surgeon Perspectives on Axillary Management Following Neoadjuvant Endocrine Therapy: Results from a Qualitative Substudy of the PELOPS Trial. Ann Surg Oncol. 2026;33(3):2267–74. https://doi.org/10.1245/s10434-025-18695-7.

Article  PubMed 

Comments (0)

No login
gif