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
| Autor: | A. Goldhirsch, Richard D. Gelber, S. Aebi, Edda Simoncini, Diana Crivellari, Barry A. Gusterson, Danielle Braun, Per Karlsson, Zhuoxin Sun, Meredith M. Regan, Manuela Rabaglio, Karen N. Price, J. Lindtner, M. Castiglione-Gertsch, Alan S. Coates, Raymond Snyder, Giuseppe Viale |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Oncology
medicine.medical_specialty Cyclophosphamide medicine.medical_treatment Estrogen receptor Breast Neoplasms Drug Administration Schedule Breast cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols mental disorders medicine Humans Prospective Studies Prospective cohort study skin and connective tissue diseases Aged Neoplasm Staging Chemotherapy business.industry Cancer Original Articles Hematology Middle Aged medicine.disease Chemotherapy regimen Tamoxifen Methotrexate Receptors Estrogen Lymphatic Metastasis Female Fluorouracil business Follow-Up Studies medicine.drug |
| Zdroj: | Aebi, S; Sun, Z; Braun, D; Price, K N; Castiglione-Gertsch, M; Rabaglio, M; Gelber, R D; Crivellari, D; Lindtner, J; Snyder, R; Karlsson, P; Simoncini, E; Gusterson, B A; Viale, G; Regan, M M; Coates, A S; Goldhirsch, A (2011). 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. Annals of oncology, 22(9), pp. 1981-7. Oxford: Oxford University Press 10.1093/annonc/mdq754 |
| Popis: | 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 node-negative 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. |
| Databáze: | OpenAIRE |
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