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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.

Viale, Giuseppe (författare)
Regan, Meredith M (författare)
Maiorano, Eugenio (författare)
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Mastropasqua, Mauro G (författare)
Golouh, Rastko (författare)
Perin, Tiziana (författare)
Brown, Robert W (författare)
Kovács, Anikó, 1961 (författare)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
Pillay, Komala (författare)
Ohlschlegel, Christian (författare)
Braye, Stephen (författare)
Grigolato, Piergiovanni (författare)
Rusca, Tiziana (författare)
Gelber, Richard D (författare)
Castiglione-Gertsch, Monica (författare)
Price, Karen N (författare)
Goldhirsch, Aron (författare)
Gusterson, Barry A (författare)
Coates, Alan S (författare)
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2008
2008
Engelska.
Ingår i: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. - 1527-7755. ; 26:9, s. 1404-10
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Nyckelord

Adult
Aged
Antineoplastic Agents
Hormonal
therapeutic use
Antineoplastic Combined Chemotherapy Protocols
administration & dosage
therapeutic use
Breast Neoplasms
chemistry
drug therapy
surgery
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
drug therapy
Predictive Value of Tests
Receptors
Estrogen
analysis
Receptors
Progesterone
analysis
Tamoxifen
administration & dosage
Treatment Outcome
Tumor Markers
Biological
analysis

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