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Chemoendocrine comp...
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.
- Article/chapterEnglish2008
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LIBRIS-ID:oai:gup.ub.gu.se/82588
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https://gup.ub.gu.se/publication/82588URI
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https://doi.org/10.1200/JCO.2007.10.6393DOI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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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.
Subject headings and genre
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MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
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MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
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Adult
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Aged
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Antineoplastic Agents
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Hormonal
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therapeutic use
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Antineoplastic Combined Chemotherapy Protocols
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administration & dosage
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therapeutic use
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Breast Neoplasms
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chemistry
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drug therapy
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surgery
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Chemotherapy
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Adjuvant
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Cyclophosphamide
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administration & dosage
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Disease-Free Survival
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Female
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Fluorouracil
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administration & dosage
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Goserelin
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administration & dosage
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Humans
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Immunohistochemistry
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Menopause
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Methotrexate
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administration & dosage
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Middle Aged
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Neoplasms
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Hormone-Dependent
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chemistry
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drug therapy
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Predictive Value of Tests
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Receptors
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Estrogen
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analysis
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Receptors
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Progesterone
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analysis
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Tamoxifen
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administration & dosage
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Treatment Outcome
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Tumor Markers
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Biological
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analysis
Added entries (persons, corporate bodies, meetings, titles ...)
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Regan, Meredith M
(author)
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Maiorano, Eugenio
(author)
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Mastropasqua, Mauro G
(author)
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Golouh, Rastko
(author)
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Perin, Tiziana
(author)
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Brown, Robert W
(author)
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Kovács, Anikó,1961Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences(Swepub:gu)xkovan
(author)
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Pillay, Komala
(author)
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Ohlschlegel, Christian
(author)
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Braye, Stephen
(author)
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Grigolato, Piergiovanni
(author)
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Rusca, Tiziana
(author)
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Gelber, Richard D
(author)
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Castiglione-Gertsch, Monica
(author)
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Price, Karen N
(author)
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Goldhirsch, Aron
(author)
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Gusterson, Barry A
(author)
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Coates, Alan S
(author)
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Göteborgs universitetInstitutionen för kliniska vetenskaper
(creator_code:org_t)
Related titles
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In:Journal of clinical oncology : official journal of the American Society of Clinical Oncology26:9, s. 1404-101527-7755
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Golouh, Rastko
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Perin, Tiziana
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Brown, Robert W
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Grigolato, Pierg ...
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Rusca, Tiziana
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University of Gothenburg