Relevant factors for the optimal duration of extended endocrine therapy in early breast cancer
| العنوان: | Relevant factors for the optimal duration of extended endocrine therapy in early breast cancer |
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| المؤلفون: | Blok, E.J., Kroep, J.R., Kranenbarg, E.M.K., Duijm-de Carpentier, M., Putter, H., Liefers, G.J., Nortier, J.W.R., Rutgers, E.J.T., Seynaeve, C.M., Velde, C.J.H. van de, IDEAL Study Grp |
| المساهمون: | Medical Oncology |
| المصدر: | Breast Cancer Research and Treatment Breast Cancer Research and Treatment, 168(2), 413-420. Springer New York Breast Cancer Research and Treatment, 168(2), 413-420 |
| بيانات النشر: | Springer US, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | 0301 basic medicine, Oncology, Cancer Research, medicine.medical_specialty, Time Factors, Antineoplastic Agents, Hormonal, Breast Neoplasms, Kaplan-Meier Estimate, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, SDG 3 - Good Health and Well-being, Internal medicine, medicine, Adjuvant therapy, Humans, Adjuvant, IDEAL, Aged, Netherlands, Extended, business.industry, Proportional hazards model, Aromatase Inhibitors, Letrozole, Middle Aged, medicine.disease, Clinical Trial, Subgroup, Postmenopause, 030104 developmental biology, Prior Therapy, Receptors, Estrogen, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Cohort, Postmenopausal, Female, business, Tamoxifen, Hormone, medicine.drug, Follow-Up Studies |
| الوصف: | Purpose For postmenopausal patients with hormone receptor-positive early breast cancer, the optimal subgroup and duration of extended endocrine therapy is not clear yet. The aim of this study using the IDEAL patient cohort was to identify a subgroup for which longer (5 years) extended therapy is beneficial over shorter (2.5 years) extended endocrine therapy. Methods In the IDEAL trial, 1824 patients who completed 5 years of adjuvant endocrine therapy (either 5 years of tamoxifen (12%), 5 years of an AI (29%), or a sequential strategy of both (59%)) were randomized between either 2.5 or 5 years of extended letrozole. For each prior therapy subgroup, the value of longer therapy was assessed for both node-negative and node-positive patients using Kaplan Meier and Cox regression survival analyses. Results In node-positive patients, there was a significant benefit of 5 years (over 2.5 years) of extended therapy (disease-free survival (DFS) HR 0.67, p = 0.03, 95% CI 0.47–0.96). This effect was only observed in patients who were treated initially with a sequential scheme (DFS HR 0.60, p = 0.03, 95% CI 0.38–0.95). In all other subgroups, there was no significant benefit of longer extended therapy. Similar results were found in patients who were randomized for their initial adjuvant therapy in the TEAM trial (DFS HR 0.37, p = 0.07, 95% CI 0.13–1.06), although this additional analysis was underpowered for definite conclusions. Conclusions This study suggests that node-positive patients could benefit from longer extended endocrine therapy, although this effect appears isolated to patients treated with sequential endocrine therapy during the first 5 years and needs validation and long-term follow-up. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1573-7217 0167-6806 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b93f1bbf320c154e35572f3628604c7aTest http://europepmc.org/articles/PMC5838141Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b93f1bbf320c154e35572f3628604c7a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15737217 01676806 |
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