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The effect of endocrine responsiveness on high-risk breast cancer treated with dose-intensive chemotherapy: results of International Breast Cancer Study Group Trial 15-95 after prolonged follow-up

Colleoni, M. ; Sun, Z. ; Martinelli, G. ; Basser, R. L. ; Coates, A. S. ; Gelber, R. D. ; Green, M. D. ; Peccatori, F. ; Cinieri, S. ; Aebi, S. ; Viale, G. ; Price, K. N. ; Goldhirsch, A.

In: Annals of Oncology, 2009, vol. 20, no. 8, p. 1344-1351

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    Titre
    • The effect of endocrine responsiveness on high-risk breast cancer treated with dose-intensive chemotherapy: results of International Breast Cancer Study Group Trial 15-95 after prolonged follow-up
    Auteur
    • Colleoni, M.. Department of Medicine, Research Unit in Medical Senology, European Institute of Oncology, Milan, Italy
    • Sun, Z.. International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA, USA
    • Martinelli, G.. Department of Medicine, Division of Hematology-Oncology, European Institute of Oncology, Milan, Italy
    • Basser, R. L.. Centre for Developmental Cancer Therapy, The Royal Melbourne Hospital, Parkville, Australia
    • Coates, A. S.. International Breast Cancer Study Group, Bern, Switzerland
    • Gelber, R. D.. International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, Frontier Science and Technology Research Foundation, Harvard School of Public Health, Boston, MA, USA
    • Green, M. D.. Department of Hematology and Medical Oncology, The Royal Melbourne and Western Hospitals, Victoria, Australia
    • Peccatori, F.. Department of Medicine, Division of Hematology-Oncology, European Institute of Oncology, Milan, Italy
    • Cinieri, S.. Department of Medicine, Division of Hematology-Oncology, European Institute of Oncology, Milan, Italy
    • Aebi, S.. Department of Medical Oncology, University Hospital, Bern
    • Viale, G.. Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy
    • Price, K. N.. International Breast Cancer Study Group Statistical Center, Frontier Science and Technology Research Foundation, Boston, MA, USA
    • Goldhirsch, A.. Department of Medicine, Division of Hematology-Oncology, European Institute of Oncology, Milan, Italy
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Annals of Oncology, 2009, vol. 20, no. 8, p. 1344-1351. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:293959
    Summary
    Background: The role of adjuvant dose-intensive chemotherapy and its efficacy according to baseline features has not yet been established. Patients and methods: Three hundred and forty-four patients were randomized to receive seven courses of standard-dose chemotherapy (SD-CT) or three cycles of dose-intensive epirubicin and cyclophosphamide (epirubicin 200 mg/m2 plus cyclophosphamide 4 mg/m2 with filgrastim and progenitor cell support). All patients were assigned tamoxifen at the completion of chemotherapy. The primary end point was disease-free survival (DFS). This paper updates the results and explores patterns of recurrence according to predicting baseline features. Results: At 8.3-years median follow-up, patients assigned DI-EC had a significantly better DFS compared with those assigned SD-CT [8-year DFS percent 47% and 37%, respectively, hazard ratio (HR) 0.76; 95% confidence interval 0.58-1.00; P = 0.05]. Only patients with estrogen receptor (ER)-positive disease benefited from the DI-EC (HR 0.61; 95% confidence interval 0.39, 0.95; P = 0.03). Conclusions: After prolonged follow-up, DI-EC significantly improved DFS, but the effect was observed only in patients with ER-positive disease, leading to the hypothesis that efficacy of DI-EC may relate to its endocrine effects. Further studies designed to confirm the importance of endocrine responsiveness in patients treated with dose-intensive chemotherapy are encouraged