Serum HER-2/neu and Response to the Aromatase Inhibitor Letrozole Versus Tamoxifen
| Autor: | Laurence M. Demers, Allan Lipton, Walter P. Carney, Harold A. Harvey, H. A. Chaudri-Ross, Suhail M. Ali, C. Brady, P. Wyld, Kim Leitzel |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Neoplasms Hormone-Dependent Receptor ErbB-2 medicine.drug_class medicine.medical_treatment Mammary gland Antineoplastic Agents Breast Neoplasms Enzyme-Linked Immunosorbent Assay Gastroenterology Disease-Free Survival Double-Blind Method Internal medicine Nitriles medicine Humans Neoplasm Metastasis Aged Neoplasm Staging Aged 80 and over Aromatase inhibitor Aromatase Inhibitors business.industry Letrozole Estrogen Antagonists Middle Aged Triazoles Antiestrogen medicine.disease Metastatic breast cancer United States Tamoxifen Treatment Outcome medicine.anatomical_structure Endocrinology Oncology Estrogen Female Hormone therapy Neoplasm Recurrence Local business Switzerland medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 21:1967-1972 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | Purpose: To determine the effect of elevated serum HER-2/neu on the response of metastatic breast cancer patients to an aromatase inhibitor versus an antiestrogen. Patients and Methods: Five hundred sixty-two estrogen receptor–positive metastatic breast cancer patients were randomized to first-line hormone therapy with either letrozole or tamoxifen. An automated enzyme-linked immunosorbent assay was used to detect serum HER-2/neu. Results: For patients with normal serum HER-2/neu (70.5%), objective response rate (ORR; 39% in letrozole-treated patients v 26% in tamoxifen-treated patients; P = .008), clinical benefit (CB; 57% v 45%; P = .016), time to progression (TTP; median, 12.2 v 8.5 months; P = .0019), and time to treatment failure (TTF; median, 11.6 v 6.2 months; P = .0066) were significantly better in patients treated with letrozole. In the elevated HER-2/neu group (29.5%), there was no significant difference in ORR (17% in letrozole-treated patients v 13% in tamoxifen-treated patients; P = .45) or CB (33% v 26%; P = .31), but there was a strong trend in favor of a longer TTP with letrozole (median, 6.1 v 3.3 months; P = .0596) and a significantly longer TTF with letrozole (median, 6.0 v 3.2 months; P = .0418). Multivariate analysis revealed that elevated serum HER-2/neu was a negative predictor for ORR and TTP. Conclusion: Patients with normal serum HER-2/neu receiving letrozole demonstrated a significantly greater ORR and CB and longer TTP and TTF than patients receiving tamoxifen. Although in patients with elevated serum HER-2/neu there was no significant difference between letrozole and tamoxifen in ORR or CB, there was a strong trend favoring longer TTP and significantly longer TTF with letrozole. |
| Databáze: | OpenAIRE |
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