HonCode

Go Back   HER2 Support Group Forums > Articles of Interest
Register Gallery FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools Display Modes
Old 07-07-2010, 09:31 AM   #1
Hopeful
Senior Member
 
Join Date: Aug 2006
Posts: 3,380
CMF more effective in TN than Her2+ BC

Supplementary editorial provided by OncologySTAT

TAKE-HOME MESSAGE

In this retrospective study of women with node-negative, operable breast cancer, the magnitude of benefit for chemotherapy was largest among women with triple-negative tumors when compared with its effect in those with HER2-positive/endocrine-receptor−negative and endocrine-receptor–positive subtypes.

STUDY IN CONTEXT


Evaluation of tumor molecular subtype is used to guide the choice of treatment in women with operable breast cancer. Genetic analysis and immunohistochemical (IHC) analysis are used to determine estrogen-receptor (ER), progesterone-receptor (PR), and human epidermal growth factor receptor 2 (HER2) status. Evidence has shown that in women with node-negative disease, ER-negative tumors respond better to chemotherapy than do ER-positive tumors. In this retrospective study, Colleoni et al compared the benefit of adjuvant chemotherapy based on IHC subtype. The analysis included data from two large, randomized phase III studies conducted by the International Breast Cancer Study Group (IBCSG), IBCSG Trial VIII and IBCSG Trial IX. IBCSG Trial VIII enrolled pre- and perimenopausal women who received sequential treatment with cyclophosphamide, methotrexate, and fluorouracil (CMF) followed by goserelin, chemotherapy alone, or goserelin alone. IBCSG Trial IX enrolled postmenopausal woman who received either sequential treatment with CMF followed by tamoxifen or treatment with tamoxifen alone. Both trials had archival tumor samples available for IHC analysis (n = 2257; 82.6% of enrolled patients) by the IBCSG Central Pathology Laboratory. Samples were evaluated for ER, PR, HER2, and Ki-67 expression.

Of these tumors, 303 (13%) were triple negative (ie, ER negative, PR negative, and HER2 negative), 119 (5%) were HER2 positive and endocrine-receptor negative, and 1835 (81%) were endocrine-receptor positive. In all, 1255 women (56%) received chemotherapy and 1002 women (44%) received no chemotherapy. The median follow-up period was 11 years.

Triple-negative tumors were more likely to be larger than 2 cm than were HER2-positive/endocrine receptor−negative or endocrine-receptor–positive tumors (57%, 49%, and 35%, respectively; P < .001), and they were also more likely to be grade 3 (78%, 68%, and 29%, respectively; P < .001). The 10-year cumulative incidence rates for relapse were similar in patients with endocrine-receptor–positive disease, regardless of whether chemotherapy treatment was received or not (19% vs 20%). However, a significant difference in the incidence of relapse was observed in patients who received chemotherapy compared with those who did not in patients with triple-negative (21% vs 36%) and HER2-positive/endocrine-receptor−negative tumors (27% vs 41%).

In multivariate analysis, chemotherapy was associated with a significant reduction in the risk of relapse for triple-negative tumors (hazard ratio [HR], 0.46; 95% CI, 0.29−0.73; interaction P = .009 vs endocrine-receptor–positive tumors). This was also true for HER2-positive/endocrine-receptor−negative tumors, but to a smaller effect (HR, 0.58; 95% CI, 0.29−1.17; interaction P = .24 vs endocrine-receptor–positive tumors).
The 10-year disease-free survival rate was significantly higher in patients with triple-negative tumors who were treated with chemotherapy vs those receiving no chemotherapy (73% vs 57%; P = .007), but not for patients with endocrine-receptor–positive tumors (74% vs 71%; P = .25).

The results of this study showed that, after more than 10 years of follow-up, adjuvant chemotherapy was associated with a greater benefit in patients with triple-negative breast cancer than in those with other IHC-derived node-negative breast cancer subtypes, specifically, HER2-positive/endocrine-receptor−negative and endocrine-receptor−positive tumors.

Abstract: http://jco.ascopubs.org/cgi/content/abstract/28/18/2966

Hopeful
Hopeful is offline   Reply With Quote
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is On

Forum Jump


All times are GMT -7. The time now is 09:54 AM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2024, vBulletin Solutions, Inc.
Copyright HER2 Support Group 2007 - 2021
free webpage hit counter