- Title
- Chemoendocrine compared with endocrine adjuvant therapies for node-negative breast cancer: Predictive value of centrally reviewed expression of estrogen and progesterone receptors - International Breast Cancer Study Group
- Creator
- Viale, Giuseppe; Regan, Meredith M.; Braye, Stephen; Grigolato, Piergiovanni; Rusca, Tiziana; Gelber, Richard D.; Castiglione-Gertsch, Monica; Price, Karen N.; Goldhirsch, Aron; Gusterson, Barry A.; Coates, Alan S.; Maiorano, Eugenio; Mastropasqua, Mauro G.; Golouh, Rastko; Perin, Tiziana; Brown, Robert W.; Kovacs, Aniko; Pillay, Komala; Ohlschlegel, Christian
- Relation
- Journal of Clinical Oncology Vol. 26, Issue 9, p. 1404-1410
- Publisher Link
- http://dx.doi.org/10.1200/JCO.2007.10.6393
- Publisher
- American Society of Clinical Oncology
- Resource Type
- journal article
- Date
- 2008
- Description
- Purpose: To centrally assess estrogen receptor (ER) and progesterone receptor (PgR) levels by immunohistochemistry and investigate their predictive value for benefit of chemo-endocrine compared with endocrine adjuvant therapy alone in two randomized clinical trials for node-negative breast cancer. Patients and Methods: International Breast Cancer Study Group Trial VIII compared cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy for 6 cycles followed by endocrine therapy with goserelin with either modality alone in pre- and perimenopausal patients. Trial IX compared three cycles of CMF followed by tamoxifen for 5 years versus tamoxifen alone in postmenopausal patients. Central Pathology Office reviewed 883 (83%) of 1,063 patients on Trial VIII and 1,365 (82%) of 1,669 on Trial IX and determined ER and PgR by immunohistochemistry. Disease-free survival (DFS) was compared across the spectrum of expression of each receptor using the Subpopulation Treatment Effect Pattern Plot methodology. Results: Both receptors displayed a bimodal distribution, with substantial proportions showing no staining (receptor absent) and most of the remainder showing a high percentage of stained cells. Chemo-endocrine therapy yielded DFS superior to endocrine therapy alone for patients with receptor-absent tumors, and in some cases also for those with low levels of receptor expression. Among patients with ER-expressing tumors, additional prediction of benefit was suggested in absent or low PgR in Trial VIII but not in Trial IX. Conclusion: Low levels of ER and PgR are predictive of the benefit of adding chemotherapy to endocrine therapy. Low PgR may add further prediction among pre- and perimenopausal but not postmenopausal patients whose tumors express ER.
- Subject
- randomized trials; clinical trials; chemotherapy; subsets
- Identifier
- http://hdl.handle.net/1959.13/43330
- Identifier
- uon:5450
- Identifier
- ISSN:0732-183X
- Language
- eng
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