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.

Détails

ID Serval
serval:BIB_A1BF80ADF5C9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
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.
Périodique
Journal of Clinical Oncology
Auteur(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]
Statut éditorial
Publié
Date de publication
2008
Volume
26
Numéro
9
Pages
1404-1410
Langue
anglais
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
Résumé
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.
Mots-clé
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
Création de la notice
05/03/2009 16:22
Dernière modification de la notice
20/08/2019 16:07
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