Breast Cancer Index and Prediction of Extended Aromatase Inhibitor Therapy Benefit in Hormone Receptor-Positive Breast Cancer from the NRG Oncology/NSABP B-42 Trial

被引：8

作者：

Mamounas, Eleftherios P. ^{[1
,17
]}

Bandos, Hanna ^{[2
,3
]}

Rastogi, Priya ^{[4
,5
]}

Zhang, Yi ^{[6
]}

Treuner, Kai ^{[6
]}

Lucas, Peter C. ^{[4
]}

Geyer, Charles E. ^{[4
]}

Fehrenbacher, Louis ^{[7
]}

Chia, Stephen K. ^{[8
,9
]}

Brufsky, Adam M. ^{[4
,5
]}

Walshe, Janice M. ^{[10
]}

Soori, Gamini S. ^{[11
]}

Dakhil, Shaker ^{[12
]}

Paik, Soonmyung ^{[13
,14
]}

Swain, Sandra M. ^{[15
]}

Sgroi, Dennis C. ^{[16
]}

Schnabel, Catherine A. ^{[6
]}

Wolmark, Norman ^{[4
]}

机构：

[1] Orlando Hlth Canc Inst, Orlando, FL USA

[2] NRG Oncol SDMC, Pittsburgh, PA USA

[3] Univ Pittsburgh, Pittsburgh, PA USA

[4] UPMC Hillman Canc Ctr, Pittsburgh, PA USA

[5] Magee Womens Hosp, Pittsburgh, PA USA

[6] A Hologic Co, Biotheranost Inc, San Diego, CA USA

[7] Kaiser Permanente Oncol Clin Trials Northern CA, Novato, CA USA

[8] British Columbia Canc Agcy, Vancouver, BC, Canada

[9] Univ British Columbia, Vancouver, BC, Canada

[10] Irish Clin Oncol Res Grp ICORG, Canc Trials Ireland, Dublin, Ireland

[11] Florida Canc Specialists, Ft Myers, FL USA

[12] CCOP Wichita Canc Ctr Kansas, Wichita, KS USA

[13] Theragenbio Inc, Pankyo, South Korea

[14] Yonsei Univ, Coll Med, Severance Biomed Sci Inst, Seoul, South Korea

[15] Georgetown Univ, Med Ctr, Georgetown Lombardi Comprehens Canc Ctr, Washington, DC USA

[16] Massachusetts Gen Hosp, Boston, MA USA

[17] Orlando Hlth Canc Inst, Surg, 1400 S Orange Ave, Orlando, FL 32806 USA

来源：

CLINICAL CANCER RESEARCH | 2024年 / 30卷 / 09期

关键词：

LATE DISTANT RECURRENCE; SURGICAL ADJUVANT BREAST; ENDOCRINE THERAPY; POSTMENOPAUSAL WOMEN; TAMOXIFEN; SCORE; RISK; LETROZOLE;

D O I：

10.1158/1078-0432.CCR-23-1977

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: BCI (H/I) has been shown to predict extended endocrine therapy (EET) benefit. We examined BCI (H/I) for EET benefit prediction in NSABP B-42, which evaluated extended letrozole therapy (ELT) in patients with hormone receptor-positive breast cancer after 5 years of ET. Experimental design: A stratified Cox model was used to analyze RFI as the primary endpoint, with DR, BCFI, and DFS as secondary endpoints. Because of a nonproportional effect of ELT on DR, time-dependent analyses were performed. Results: The translational cohort included 2,178 patients (45% BCI (H/I)-High, 55% BCI (H/I)-Low). ELT showed an absolute 10-year RFI benefit of 1.6% (P = 0.10), resulting in an underpowered primary analysis (50% power). ELT benefit and BCI (H/I) did not show a significant interaction for RFI (BCI (H/I)-Low: 10 years absolute benefit 1.1% [HR, 0.70; 95% confidence interval (CI), 0.43-1.12; P = 0.13]; BCI (H/I)-High: 2.4% [HR, 0.83; 95% CI, 0.55-1.26; P = 0.38]; P-interaction = 0.56). Time-dependent DR analysis showed that after 4 years, BCI (H/I)-High patients had significant ELT benefit (HR = 0.29; 95% CI, 0.12-0.69; P < 0.01), whereas BCI (H/I)-Low patients were less likely to benefit (HR, 0.68; 95% CI, 0.33-1.39; P = 0.29; P-interaction = 0.14). Prediction of ELT benefit by BCI (H/I) was more apparent in the HER2- subset after 4 years (ELT-by-BCI (H/I) P-interaction = 0.04). Conclusions: BCI (H/I)-High versus BCI (H/I)-Low did not show a statistically significant difference in ELT benefit for the primary endpoint (RFI). However, in time-dependent DR analysis, BCI (H/I)-High patients experienced statistically significant benefit from ELT after 4 years, whereas (H/I)-Low patients did not. Because BCI (H/I) has been validated as a predictive marker of EET benefit in other trials, additional follow-up may enable further characterization of BCI's predictive ability.

引用

页码：1984 / 1991

页数：8

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