WFRF:(Simoncini E)
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Differential efficacy of three cycles of CMF followed by tamoxifen in patients with ER-positive and ER-negative tumors: Long-term follow up on IBCSG Trial IX
- Aebi, S (author)
- Sun, Z (author)
- Braun, D (author)
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- Price, KN (author)
- Castiglione-Gertsch, M (author)
- Rabaglio, M (author)
- Gelber, RD (author)
- Crivellari, D (author)
- Lindtner, J (author)
- Snyder, R (author)
- Simoncini, E (author)
- Gusterson, BA (author)
- Viale, G (author)
- Regan, MM (author)
- Coates, AS (author)
- Goldhirsch, A (author)
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- (creator_code:org_t)
- 2011
- 2011
- English.
- In: ANNALS OF ONCOLOGY. - 0923-7534. ; 22:9, s. 1981-1987
- Journal article (peer-reviewed)
Abstract
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- Abstract: Background: The benefit of adjuvant chemotherapy in postmenopausal patients with estrogen receptor (ER)positive lymph node-negative breast cancer is being reassessed. Patients and methods: After stratification by ER status, 1669 postmenopausal patients with operable lymph nodenegative breast cancer were randomly assigned to three 28-day courses of 'classical' CMF (cyclophosphamide, methotrexate, 5-fluorouracil) chemotherapy followed by tamoxifen for 57 months (CMF/tamoxifen) or to tamoxifen alone for 5 years. Results: ERs were positive in 81% of tumors. At a median follow-up of 13.1 years, patients with ER-positive breast cancers did not benefit from CMF [13-year disease-free survival (DFS) 64% CMF/tamoxifen, 66% tamoxifen; P = 0.99], whereas CMF substantially improved the prognosis of patients with ER-negative breast cancer (13-year DFS 73% versus 57%, P = 0.001). Similarly, breast cancer-free interval (BCFI) was identical in the ER-positive cohort but significantly improved by chemotherapy in the ER-negative cohort (13-year BCFI 80% versus 63%, P = 0.001). CMF had no influence on second nonbreast malignancies or deaths from other causes. Conclusion: CMF is not beneficial in postmenopausal patients with node-negative ER-positive breast cancer but is highly effective within the ER-negative cohort. In the future, other markers of chemotherapy response may define a subset of patients with ER-positive tumors who may benefit from adjuvant chemotherapy.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- adjuvant chemotherapy
- breast cancer
- estrogen receptor
- postmenopause
- tamoxifen
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- ref (subject category)
- art (subject category)
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- Aebi, S
- Sun, Z
- Braun, D
- Price, KN
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- Rabaglio, M
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- Gelber, RD
- Crivellari, D
- Lindtner, J
- Snyder, R
- Karlsson, Per, 1 ...
- Simoncini, E
- Gusterson, BA
- Viale, G
- Regan, MM
- Coates, AS
- Goldhirsch, A
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- University of Gothenburg
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