Impact of premenopausal status at breast cancer diagnosis in women entered on the placebo-controlled NCIC CTG MA17 trial of extended adjuvant letrozole

被引:63
作者
Goss, P. E. [1 ]
Ingle, J. N. [2 ]
Martino, S. [3 ]
Robert, N. J. [4 ]
Muss, H. B. [5 ,6 ]
Livingston, R. B. [7 ]
Davidson, N. E. [8 ,9 ]
Perez, E. A. [10 ]
Chavarri-Guerra, Y. [1 ]
Cameron, D. A. [11 ,12 ]
Pritchard, K. I. [13 ]
Whelan, T. [14 ]
Shepherd, L. E. [15 ]
Tu, D. [15 ]
机构
[1] Massachusetts Gen Hosp, Ctr Canc, Boston, MA 02114 USA
[2] Mayo Clin, Dept Oncol, Div Med Oncol, Rochester, MN USA
[3] Los Angeles Clin & Res Inst, Breast Canc Div, Santa Monica, CA USA
[4] Inova Fairfax Hosp, Virgina Canc Specialists, Fairfax, VA USA
[5] Univ N Carolina, Dept Med, Chapel Hill, NC USA
[6] Univ N Carolina, Lineberger Comprehens Canc Ctr, Chapel Hill, NC 27599 USA
[7] Univ Washington, Seattle, WA 98195 USA
[8] Univ Pittsburgh, Sch Med, Inst Canc, Pittsburgh, PA USA
[9] Univ Pittsburgh, Sch Med, UPMC Canc Ctr, Pittsburgh, PA USA
[10] Mayo Clin, Ctr Canc, Jacksonville, FL USA
[11] Western Gen Hosp, Edinburgh Breast Unit, Edinburgh EH4 2XU, Midlothian, Scotland
[12] Univ Edinburgh, Edinburgh, Midlothian, Scotland
[13] Univ Toronto, Sunnybrook Odette Reg Canc Ctr, Toronto, ON, Canada
[14] McMaster Univ, Dept Oncol, Hamilton, ON, Canada
[15] Natl Canc Inst Canada, Clin Trials Grp, Kingston, ON, Canada
关键词
adjuvant therapy; aromatase inhibitors; breast cancer; extended therapy; letrozole; menopausal status; ENDOCRINE THERAPY; AROMATASE INHIBITORS; ESTROGEN-RECEPTOR; TAMOXIFEN THERAPY; RANDOMIZED-TRIAL; UPDATED FINDINGS;
D O I
10.1093/annonc/mds330
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
MA17 showed improved outcomes in postmenopausal women given extended letrozole (LET) after completing 5 years of adjuvant tamoxifen. Exploratory subgroup analyses of disease-free survival (DFS), distant DFS (DDFS), overall survival (OS), toxic effects and quality of life (QOL) in MA17 were performed based on menopausal status at breast cancer diagnosis. At diagnosis, 877 women were premenopausal and 4289 were postmenopausal. Extended LET was significantly better than placebo (PLAC) in DFS for premenopausal [hazard ratio (HR) = 0.26, 95% confidence interval (CI) 0.13-0.55; P = 0.0003] and postmenopausal women (HR = 0.67; 95% CI 0.51-0.89; P = 0.006), with greater DFS benefit in those premenopausal (interaction P = 0.03). In adjusted post-unblinding analysis, those who switched from PLAC to LET improved DDFS in premenopausal (HR = 0.15; 95% CI 0.03-0.79; P = 0.02) and postmenopausal women (HR = 0.45; 95% CI 0.22-0.94; P = 0.03). Extended LET after 5 years of tamoxifen was effective in pre- and postmenopausal women at diagnosis, and significantly better in those premenopausal. Women premenopausal at diagnosis should be considered for extended adjuvant therapy with LET if menopausal after completing tamoxifen.
引用
收藏
页码:355 / 361
页数:8
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