This Korean clinical study found for ER+ breast cancer, Pr negative status may predict poorer outcomes with Tamoxifen treatment and Her2 positive status may be best treated with long-term Her2-target therapy. I believe similar findings have been developed by other studies.--bird
J Cancer Res Clin Oncol. 2011 Feb 16. [Epub ahead of print]
Clinical significance of progesterone receptor and HER2 status in estrogen receptor-positive, operable breast cancer with adjuvant tamoxifen.
Moon YW,
Park S,
Sohn JH,
Kang DR,
Koo JS,
Park HS,
Chung HC,
Park BW.
Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Abstract
PURPOSE: To evaluate prognostic factors in estrogen receptor (ER)-positive, operable breast cancer focusing on the progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2).
PATIENTS AND METHODS: A total of 819 patients with ER-positive, operable breast cancer were enrolled. All patients received upfront adjuvant tamoxifen, as stipulated by eligibility criteria. Prognostic values of the PR status and HER2 status were evaluated using Cox regression.
RESULTS: Of all patients enrolled, 72% were PR positive and 20% were HER2 positive. PR and HER2 status were inversely correlated (P = 0.014). PR-negative tumors were associated with older age over 50 years (P < 0.001) and higher histologic grade (P = 0.024). HER2 overexpression correlated with older age over 50 years (P = 0.007), higher T stage (P = 0.010), and higher histologic grade (P = 0.047). For recurrence, PR negativity was a poor prognostic factor before 5 years postsurgery (hazard ratio = 1.57; P = 0.049) and HER2 overexpression was a consistent poor prognostic factor over all time periods (hazard ratio = 1.93; P = 0.001) in the multivariate model adjusted by age, T/N stage, and histologic grade.
CONCLUSIONS: In ER-positive, operable breast cancer, PR negativity may provide additional information on poor prognosis or tamoxifen resistance during adjuvant tamoxifen therapy within 5 years postsurgery. HER2 overexpression was a poor prognostic factor consistently throughout time. This suggests that an alternative adjuvant strategy, possibly incorporating prolonged HER2-targeted therapy, needs to be evaluated for HER2-overexpressing tumors.
PMID: 21327800 [PubMed - as supplied by publisher]
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