Neoadjuvant systemic chemotherapy (NST) can effect freedom from locoregional and distant disease, improve surgical options by reducing the extent of required surgery, and provide useful early information on tumour biology and responsiveness to chemotherapy. Taxane-containing regimens are widely used both as monotherapy and in combination with anthracyclines. However, questions remain regarding choice of agents, optimal treatment duration and whether sequential or simultaneous administration of these agents is best. In future NST may be tailored to optimise treatment for individual patients, based upon improved knowledge of the efficacy and tolerability of different chemotherapy regimens and the prognostic significance of pathologic complete remission and/or othermarkers of likely response to therapy.
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