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, by analyzing the prognostic and predictive value of tumor-infiltrating lymphocytes (TILs) in the TNBC cohort of the IBCSG trial 22-00, identified a subgroup of tumors, the so-called lymphocyte-predominant breast cancer (LPBC), for which metronomic CM confers a greater, even not statistically significant, clinical benefit.
Even if this trial was not sufficiently powered to address the question regarding the role of angiogenesis bloc at the source by using metronomic chemotherapy, it was pioneer for subsequent trials investigating the same question, such as the BEATRICE trial and the IBCSG 22-00 one, published some years later.
Summary of Major Sentinel Lymph Node (SLN) Trials Trial SLN Status NSABP B-32 (7) Negative IBCSG 23-01 (67) Positive 1 or more micrometastases ACOSOG Z0011 (13,14) Positive 1 or 2 positive SLNs AMAROS (76) Positive 1 or 2 positive SLNs Trial Comparison NSABP B-32 (7) SLNB alone versus SLNB + ALND in T1 to T2, cN0 patients undergoing mastectomy or BCS IBCSG 23-01 (67) SLNB alone versus SLNB + ALND in T1 to T2 patients undergoing mastectomy or BCS ACOSOG Z0011 (13,14) SLNB alone versus SLNB + ALND in T1 to T2, cN0 patients undergoing BCS and whole-breast RT AMAROS (76) ALND versus axillary RT in T1 to T2, cN0 patients treated with Trial No.
The IBCSG 23-01  and AATRM  trials are a welcome and timely addition to the gaps that were remaining after the Z0011 trial first created controversy and renewed interest in the topic of axillary dissection in SNL positive patients.
The Z0011 trial included only those breast cancer patients undergoing breast conservation surgery and all patients receiving whole breast irradiation whereas the IBCSG 2301 trial included both mastectomy and breast conservative surgery patients.
Similar with Z0011, the IBCSG 23-01 trial included only patients with micrometastases at SLNB; patients were divided into two groups as ALND and no surgery.
(5.) Gelber RD, Gelber S; for the International Breast Cancer Study Group (IBCSG) and the Breast International Group (BIG).
The National Surgical Adjuvant Breast and Bowel Project (NSABP-30) study showed significant survival advantage with CIA independently of estrogen receptor status (NSABP-30), but subsequent analysis of this study (4) and the International Breast Cancer Study Group (IBCSG 13-93, VI, VIII) study indicated that the CIA-related survival effect was limited in patients who were hormone receptor positive (5, 27, 28).
(22,60,61) The International Breast Cancer Study Group (IBCSG) conducted a series of studies comparing chemoendocrine therapy to endocrine therapy alone in years before the establishment of IHC testing.
King then stated important prospective randomized trials about axillary manegament like ACOSOG Z0011, AMAROS, IBCSG 23-01, OTOASOR, and AATRM.
Differential efficacy of three cycles of CMF followed by tamoxifen in patients with [ER.sub.-]positive and [ER.sub.-]negative tumors: long-term follow up on IBCSG Trial IX.
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