Influence of Endocrine-Related Factors on Response to Perioperative Chemotherapy for Patients With Node-Negative Breast Cancer
- 1 November 2001
- journal article
- clinical trial
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 19 (21), 4141-4149
- https://doi.org/10.1200/jco.2001.19.21.4141
Abstract
PURPOSE: We investigated tumor- and patient-related features that might influence the response to perioperative chemotherapy (PeCT) compared with no adjuvant therapy for patients with node-negative breast cancer. PATIENTS AND METHODS: A total of 1,275 patients were randomized to either no adjuvant treatment (427 patients) or PeCT (848 patients). The following variables thought to have prognostic significance were evaluated: grade, tumor size, estrogen (ER) and progesterone receptor (PgR) content (absent; low, 1 to 9 fmol/mg cytosol protein; or positive, ≥ 10 fmol/mg cytosol protein), c-erbB-2 overexpression, menopausal status, and age. Cox proportional hazards regression models were used to assess the relative influence of these factors to predict the effect of PeCT on disease-free survival (DFS). Median follow-up was 13.5 years. RESULTS: The 10-year DFS percentage for 692 premenopausal patients did not significantly differ between the PeCT and no-adjuvant-treatment groups: 61% and 59%, respectively (relative risk [RR], 0.95; 95% confidence interval [CI], 0.75 to 1.20; P = .70). No predictive factors were identified. For 583 postmenopausal patients, 10-year DFS percentages for the groups were 63% and 58%, respectively (RR, 0.75; 95% CI, 0.58 to 0.93; P = .03). The absence of expression of ER, PgR, or both ER and PgR was the most important factor predicting improved outcome with PeCT among postmenopausal patients. The 10-year DFS percentages were 85% and 53% for the steroid hormone receptor–absent cohort of treated and untreated patients, respectively (RR, 0.18; 95% CI, 0.06 to 0.49; P = .0009). CONCLUSION: The role of PeCT should be explored for patients whose primary tumors do not express steroid hormone receptors, because it is likely that early initiation of treatment is exclusively relevant for such patients.Keywords
This publication has 29 references indexed in Scilit:
- Polychemotherapy for early breast cancer: an overview of the randomised trialsThe Lancet, 1998
- Stimulation of Human Breast Cancer MCF-7 Cells with Estrogen Prevents Cell Cycle Arrest by HMG-CoA Reductase InhibitorsBiochemical and Biophysical Research Communications, 1996
- Oestradiol stimulates growth of oestrogen receptor-negative MDA-MB-231 breast cancer cells in immunodeficient mice by reducing cell lossEuropean Journal Of Cancer, 1994
- Microtubule disruption induced by estradiol in estrogen receptor-positive and -negative human breast cancer cell linesCarcinogenesis: Integrative Cancer Research, 1994
- Comparison of ligand binding assay and enzyme immunoassay of oestrogen receptor in human breast cancer cytosolsBreast Cancer Research and Treatment, 1990
- Prolonged Disease-Free Survival after One Course of Perioperative Adjuvant Chemotherapy for Node-Negative Breast CancerNew England Journal of Medicine, 1989
- Combination Adjuvant Chemotherapy for Node-Positive Breast CancerNew England Journal of Medicine, 1988
- Regulation of breast tumor growth by high dose estrogen is independent of the presence of estrogen receptorsBreast Cancer Research and Treatment, 1985
- Estrogen Receptors and Responses to Chemotherapy and Hormonal Therapy in Advanced Breast CancerNew England Journal of Medicine, 1978
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958