Effect of dose-dense adjuvant chemotherapy in hormone receptor positive/HER2-negative early breast cancer patients according to immunohistochemically defined luminal subtype: an exploratory analysis of the GIM2 trial

被引：8

作者：

Conte, Benedetta ^{[1
,2
]}

Bruzzone, Marco ^{[3
]}

Lambertini, Matteo ^{[4
,5
]}

Poggio, Francesca ^{[1
]}

Bighin, Claudia ^{[1
]}

Blondeaux, Eva ^{[1
]}

De Laurentiis, Michelino ^{[6
]}

Valle, Enrichetta ^{[7
]}

Cognetti, Francesco ^{[8
]}

Nistico, Cecilia ^{[9
]}

De Placido, Sabino ^{[10
]}

Garrone, Ornella ^{[11
]}

Gamucci, Teresa ^{[12
,13
]}

Montemurro, Filippo ^{[14
]}

Puglisi, Fabio ^{[15
,16
]}

Cardinali, Barbara ^{[17
]}

Fregatti, Piero ^{[18
,19
]}

Miglietta, Loredana ^{[1
]}

Boccardo, Francesco ^{[4
]}

Ceppi, Marcello ^{[3
]}

Del Mastro, Lucia ^{[17
]}

机构：

[1] IRCCS Osped Policlin San Martino, Med Oncol Unit 2, Largo Rosanna Benzi 10, I-16132 Genoa, GE, Italy

[2] August Pi & Sunyer Biomed Res Inst, Translat Genom & Targeted Therapeut Solid Tumors, Carrer Rossello 149, Barcelona 08036, Spain

[3] IRCCS Osped Policlin San Martino, Clin Epidemiol Unit, Largo Rosanna Benzi 10, I-16132 Genoa, GE, Italy

[4] IRCCS Osped Policlin San Martino, UOC Clin Oncol Med, Dept Med Oncol, Largo Rosanna Benzi 10, I-1632 Genoa, GE, Italy

[5] Univ Genoa, Sch Med, Dept Internal Med & Med Specialties DiMI, Viale Benedetto XV 10, I-16132 Genoa, GE, Italy

[6] Ist Nazl Tumori Fdn G Pascale, Breast Unit, Via Mariano Semmola 53, I-80131 Naples, NA, Italy

[7] Osped Businco, Dept Med Oncol, Via Edward Jenner 1, I-09121 Cagliari, CA, Italy

[8] Univ Roma La Sapienza, Dept Clin & Mol Med, Viale Regina Elena 324, I-00161 Rome, RM, Italy

[9] Ist Nazl Tumori Regina Elena, Dept Med Oncol 1, Via Elio Chianesi 53, I-00128 Rome, RM, Italy

[10] Univ Naples Federico II, Dept Clin Med & Surg, Via Sergio Pansini 5, I-80131 Naples, NA, Italy

[11] Azienda Osped Santa Croce & Carle, Dept Oncol, Breast Unit, Via Michele Coppino 26, I-12100 Cuneo, CN, Italy

[12] Osped Sandro Pertini, Dept Med Oncol, Via Monti Tiburtini 385-389, I-00157 Rome, RM, Italy

[13] Osped SS Trinita, Dept Med Oncol, I-03039 Sora, FR, Italy

[14] FPO IRCCS, Candiolo Canc Inst, Multidisciplinary Oncol Outpatient Clin, Str Prov 42, I-10060 Turin, TO, Italy

[15] Univ Udine, Dept Med, Piazzale Massimiliano Kolbe 4, I-33100 Udine, Italy

[16] Natl Canc Inst, Dept Med Oncol, IRCCS Ctr Riferimento Oncol Aviano, Via Franco Gallini 2, I-33081 Aviano, PN, Italy

[17] IRCCS Osped Policlin San Martino, Breast Unit, Largo Rosanna Benzi 10, I-16132 Genoa, GE, Italy

[18] Univ Genoa, Dept Surg Sci & Integrated Diagnost DISC, Viale Benedetto XV 6, I-1612 Genoa, GE, Italy

[19] IRCCS Policlin San Martino, Dept Surg, Largo Rosanna Benzi 10, I-1632 Genoa, GE, Italy

来源：

EUROPEAN JOURNAL OF CANCER | 2020年 / 136卷

关键词：

Breast cancer; Dose-dense chemotherapy; Hormone receptor-positive; Luminal subtype; INTERNATIONAL EXPERT CONSENSUS; PHASE-III; PLUS CYCLOPHOSPHAMIDE; PRIMARY THERAPY; WOMEN; DOCETAXEL; SURVIVAL; BENEFIT; KI67; RECURRENCE;

D O I：

10.1016/j.ejca.2020.05.007

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Luminal A-like and luminal B-like subtypes have different sensitivity to (neo)adjuvant chemotherapy, but their role in predicting dose-dense (DD) efficacy in the high-risk setting is unknown. In this exploratory analysis of the Gruppo Italiano Mammella 2 (GIM2) trial, we investigated DD efficacy according to luminal-like subtypes. Methods: Patients with node-positive early breast cancer were randomised to receive either DD or standard-interval (SI) anthracycline-based chemotherapy followed by paclitaxel. In our analysis, luminal A-like cohort was identified as having a Ki67 < 20% and a progesterone receptor (PgR) >= 20%; luminal B-like cohort as having a Ki67 >= 20% and/or a PgR < 20%. Results: Out of 2003 patients enrolled in the GIM2 trial, 412 had luminal A-like and 638 luminal B-like breast cancer. After a median follow-up of 7.9 years, disease-free survival (DFS) was 80.8% (95% confidence interval [CI] 76.4-84.5) and 70.5% (66.5-74.2) in luminal A-like and luminal B-like cohorts; overall survival (OS) was 91.6% (88.2-94.1) and 85.1% (81.7-87.9), respectively. We found no significant interaction between treatment and luminal subtype (interaction p = 0.603 and 0.535 for DFS and OS, respectively). When DD efficacy was investigated separately in each cohort, luminal-B like cohort appeared to benefit more from the DD schedule both in terms of DFS (unadjusted hazard ratio [HR] 0.72 [95% CI 0.54-0.96]) and OS (unadjusted HR 0.61 [95% CI 0.40-0.94]), compared with the luminal A-like cohort (unadjusted HR for DFS 0.89 [95% CI 0.59-1.33]; unadjusted HR for OS 0.83 [95% CI 0.45-1.54]). Conclusions: No significant interaction between luminal-like subtype and treatment was observed. Patients in the luminal B-like cohort seemed to benefit more from DD schedule. (C) 2020 Elsevier Ltd. All rights reserved.

引用

页码：43 / 51

页数：9

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