Chemoendocrine compared with endocrine adjuvant therapies for node-negative breast cancer: predictive value of centrally reviewed expression of estrogen and progesterone receptors--International Breast Cancer Study Group.

Details

Serval ID
serval:BIB_A1BF80ADF5C9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Chemoendocrine compared with endocrine adjuvant therapies for node-negative breast cancer: predictive value of centrally reviewed expression of estrogen and progesterone receptors--International Breast Cancer Study Group.
Journal
Journal of Clinical Oncology
Author(s)
Viale G., Regan M.M., Maiorano E., Mastropasqua M.G., Golouh R., Perin T., Brown R.W., Kovács A., Pillay K., Ohlschlegel C., Braye S., Grigolato P., Rusca T., Gelber R.D., Castiglione-Gertsch M., Price K.N., Goldhirsch A., Gusterson B.A., Coates A.S.
ISSN
1527-7755[electronic]
Publication state
Published
Issued date
2008
Volume
26
Number
9
Pages
1404-1410
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
Abstract
PURPOSE: To centrally assess estrogen receptor (ER) and progesterone receptor (PgR) levels by immunohistochemistry and investigate their predictive value for benefit of chemo-endocrine compared with endocrine adjuvant therapy alone in two randomized clinical trials for node-negative breast cancer. PATIENTS AND METHODS: International Breast Cancer Study Group Trial VIII compared cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy for 6 cycles followed by endocrine therapy with goserelin with either modality alone in pre- and perimenopausal patients. Trial IX compared three cycles of CMF followed by tamoxifen for 5 years versus tamoxifen alone in postmenopausal patients. Central Pathology Office reviewed 883 (83%) of 1,063 patients on Trial VIII and 1,365 (82%) of 1,669 on Trial IX and determined ER and PgR by immunohistochemistry. Disease-free survival (DFS) was compared across the spectrum of expression of each receptor using the Subpopulation Treatment Effect Pattern Plot methodology. RESULTS: Both receptors displayed a bimodal distribution, with substantial proportions showing no staining (receptor absent) and most of the remainder showing a high percentage of stained cells. Chemo-endocrine therapy yielded DFS superior to endocrine therapy alone for patients with receptor-absent tumors, and in some cases also for those with low levels of receptor expression. Among patients with ER-expressing tumors, additional prediction of benefit was suggested in absent or low PgR in Trial VIII but not in Trial IX. CONCLUSION: Low levels of ER and PgR are predictive of the benefit of adding chemotherapy to endocrine therapy. Low PgR may add further prediction among pre- and perimenopausal but not postmenopausal patients whose tumors express ER.
Keywords
Adult, Aged, Antineoplastic Agents, Hormonal/therapeutic use, Antineoplastic Combined Chemotherapy Protocols/administration & dosage, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Breast Neoplasms/chemistry, Breast Neoplasms/drug therapy, Chemotherapy, Adjuvant, Cyclophosphamide/administration & dosage, Disease-Free Survival, Female, Fluorouracil/administration & dosage, Goserelin/administration & dosage, Humans, Immunohistochemistry, Menopause, Methotrexate/administration & dosage, Middle Aged, Neoplasms, Hormone-Dependent/chemistry, Neoplasms, Hormone-Dependent/drug therapy, Predictive Value of Tests, Receptors, Estrogen/analysis, Receptors, Progesterone/analysis, Tamoxifen/administration & dosage, Treatment Outcome, Tumor Markers, Biological/analysis
Pubmed
Web of science
Create date
05/03/2009 15:22
Last modification date
20/08/2019 15:07
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