Adjuvant Sequencing of Tamoxifen and Anastrozole Is Superior to Tamoxifen Alone in Postmenopausal Women with Low Proliferating Breast Cancer

To assess the predictive value of Ki67 expression in postmenopausal hormone receptor-positive early-breast cancer patients, who were either treated with adjuvant tamoxifen (TAM) alone or with TAM followed by anastrozole (ANA). Expression of Ki67 was determined centrally by immunohistochemistry on wh...

Full description

Saved in:
Bibliographic Details
Published in:Clinical cancer research 2011-12, Vol.17 (24), p.7828-7834
Main Authors: BAGO-HORVATH, Zsuzsanna, RUDAS, Margaretha, HAID, Anton, GRUBER, Christine, POSTLBERGER, Sabine, FILIPITS, Martin, GNANT, Michael, DUBSKY, Peter, JAKESZ, Raimund, SINGER, Christian F, KEMMERLING, Ralf, GREIL, Richard, JELEN, Andrea, BÖHM, Gerhard, JASAREVIC, Zerina
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antineoplastic agents
Antineoplastic Agents, Hormonal - administration & dosage
Antineoplastic Agents, Hormonal - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Breast Neoplasms - drug therapy
Breast Neoplasms - metabolism
Breast Neoplasms - pathology
Cell Proliferation
Chemotherapy, Adjuvant - methods
Disease-Free Survival
Female
Gynecology. Andrology. Obstetrics
Humans
Immunohistochemistry
Kaplan-Meier Estimate
Ki-67 Antigen - analysis
Mammary gland diseases
Medical sciences
Middle Aged
Nitriles - administration & dosage
Nitriles - therapeutic use
Outcome Assessment (Health Care) - statistics & numerical data
Pharmacology. Drug treatments
Postmenopause
Prognosis
Proportional Hazards Models
Randomized Controlled Trials as Topic
Tamoxifen - administration & dosage
Tamoxifen - therapeutic use
Triazoles - administration & dosage
Triazoles - therapeutic use
Tumors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To assess the predictive value of Ki67 expression in postmenopausal hormone receptor-positive early-breast cancer patients, who were either treated with adjuvant tamoxifen (TAM) alone or with TAM followed by anastrozole (ANA). Expression of Ki67 was determined centrally by immunohistochemistry on whole tissue sections of postmenopausal endocrine-responsive breast cancers from patients who had been enrolled in the prospectively randomized Austrian Breast and Colorectal Cancer Study Group Trial 8, and had received TAM for 5 years, or TAM for 2 years followed by ANA for 3 years. Ki67 expression was evaluated both as a continuous variable and dichotomized to low (≤10%) and high (>10%). Recurrence-free survival (RFS) and overall survival (OS) were analyzed using Cox models adjusted for clinical and pathologic parameters. Patients with a high Ki67 expression (394/1,587; 23%) had a significantly shorter RFS (adjusted HR for recurrence = 1.90, 95% CI: 1.37-2.64, P = 0.0001) and OS (adjusted HR for death = 1.78, 95% CI: 1.18-2.70, P = 0.006). In women with breast tumors expressing medium or high ER levels (n = 1,438), the interaction between Ki67 and adjuvant endocrine treatment was significant for RFS (P = 0.03). TAM followed by ANA was superior to TAM alone in patients with low Ki67 (adjusted HR = 0.53, 95% CI: 0.34-0.83, P = 0.005) but not in high Ki67 disease (adjusted HR = 1.18, 95% CI: 0.66-1.89, P = 0.68). Adjuvant sequencing of TAM and ANA is superior to TAM alone, particularly in postmenopausal women with medium or high ER expressing, low proliferating breast cancer.
ISSN:1078-0432
1557-3265
DOI:10.1158/1078-0432.CCR-11-1846