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
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