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Predictors of early relapse in postmenopausal women with hormone receptor-positive breast cancer in the BIG 1-98 trial

Mauriac, L. ; Keshaviah, A. ; Debled, M. ; Mouridsen, H. ; Forbes, JF ; Thürlimann, B. ; Paridaens, R. ; Monnier, A. ; Láng, I. ; Wardley, A. ; Nogaret, J-M ; Gelber, RD ; Castiglione-Gertsch, M. ; Price, KN ; Coates, AS ; Smith, I. ; Viale, G. ; Rabaglio, M. ; Zabaznyi, N. ; Goldhirsch, A.

In: Annals of Oncology, 2007, vol. 18, no. 5, p. 859-867

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    Titre
    • Predictors of early relapse in postmenopausal women with hormone receptor-positive breast cancer in the BIG 1-98 trial
    Auteur
    • Mauriac, L.. French Breast Cancer Group, Institut Bergonié Bordeaux, France
    • Keshaviah, A.. International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, Boston, MA, USA
    • Debled, M.. Institut Bergonié, Bordeaux, France
    • Mouridsen, H.. Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark
    • Forbes, JF. Australian New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle, New South Wales, Australia
    • Thürlimann, B.. Senology Center of Eastern Switzerland, Switzerland, Swiss Group for Clinical Cancer Research, Kantonsspital, St Gallen
    • Paridaens, R.. University Hospital Gasthuisberg, Catholic University of Leuven, Belgium
    • Monnier, A.. Centre Hospitalier Belfort, Montbeliard, France
    • Láng, I.. National Institute of Oncology, Budapest, Hungary
    • Wardley, A.. Christie Hospital NHS Trust, South Manchester University Hospital Trust, Manchester, UK
    • Nogaret, J-M. Jules Bordet Institute, Brussels, Belgium
    • Gelber, RD. International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, Harvard School of Public Health and Frontier Science and Technology Research Foundation, Boston, MA, USA
    • Castiglione-Gertsch, M.. International Breast Cancer Study Group Coordinating Center and Inselspital, Berne, Switzerland
    • Price, KN. International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation, Boston, MA, USA
    • Coates, AS. International Breast Cancer Study Group, Berne, Switzerland and University of Sydney, Australia
    • Smith, I.. The Royal Marsden Hospital, London, UK
    • Viale, G.. European Institute of Oncology, Milan, Italy
    • Rabaglio, M.. International Breast Cancer Study Group Coordinating Center and Inselspital, Berne, Switzerland
    • Zabaznyi, N.. Moscow Municipal Oncology Hospital #62, Stepanovskoe, Krasnogorski Province, Moscow Region, Russia
    • Goldhirsch, A.. European Institute of Oncology, Milan, Italy and Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Annals of Oncology, 2007, vol. 18, no. 5, p. 859-867. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:293016
    Summary
    Background: Aromatase inhibitors are considered standard adjuvant endocrine treatment of postmenopausal women with hormone receptor-positive breast cancer, but it remains uncertain whether aromatase inhibitors should be given upfront or sequentially with tamoxifen. Awaiting results from ongoing randomized trials, we examined prognostic factors of an early relapse among patients in the BIG 1-98 trial to aid in treatment choices. Patients and methods: Analyses included all 7707 eligible patients treated on BIG 1-98. The median follow-up was 2 years, and the primary end point was breast cancer relapse. Cox proportional hazards regression was used to identify prognostic factors. Results: Two hundred and eighty-five patients (3.7%) had an early relapse (3.1% on letrozole, 4.4% on tamoxifen). Predictive factors for early relapse were node positivity (P < 0.001), absence of both receptors being positive (P < 0.001), high tumor grade (P < 0.001), HER-2 overexpression/amplification (P < 0.001), large tumor size (P = 0.001), treatment with tamoxifen (P = 0.002), and vascular invasion (P = 0.02). There were no significant interactions between treatment and the covariates, though letrozole appeared to provide a greater than average reduction in the risk of early relapse in patients with many involved lymph nodes, large tumors, and vascular invasion present. Conclusion: Upfront letrozole resulted in significantly fewer early relapses than tamoxifen, even after adjusting for significant prognostic factors