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Outcomes of special histotypes of breast cancer after adjuvant endocrine therapy with letrozole or tamoxifen in the monotherapy cohort of the BIG 1-98 trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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  • E Munzone
  • A Giobbie-Hurder
  • B A Gusterson
  • E Mallon
  • G Viale
  • B Thürlimann
  • B Ejlertsen
  • G MacGrogan
  • F Bibeau
  • G Lelkaitis
  • K N Price
  • R D Gelber
  • A S Coates
  • A Goldhirsch
  • M Colleoni
  • International Breast Cancer Study Group and the BIG 1-98 Collaborative Group
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BACKGROUND: We investigated the outcomes of postmenopausal women with hormone receptor-positive, early breast cancer with special histotypes (mucinous, tubular, or cribriform) enrolled in the monotherapy cohort of the BIG 1-98 trial.

PATIENTS AND METHODS: The intention-to-treat BIG 1-98 monotherapy cohort (5 years of therapy with tamoxifen or letrozole) included 4922 women, of whom 4091 had central pathology review. Histotype groups were defined as: mucinous (N = 100), tubular/cribriform (N = 83), ductal (N = 3257), and other (N = 651). Of 183 women with either mucinous or tubular/cribriform tumors, 96 were randomly assigned to letrozole and 87 to tamoxifen. Outcomes assessed were disease-free survival (DFS), overall survival (OS), breast cancer-free interval (BCFI), and distant recurrence-free interval (DRFI). Median follow-up in the analytic cohort was 8.1 years.

RESULTS: Women with tubular/cribriform breast cancer had the best outcomes for all end points compared with the other three histotypes, and had less breast cancer recurrence (97.5% 5-year BCFI) than those with mucinous (93.5%), ductal (88.9%), or other (89.9%) histotypes. Patients with mucinous or tubular/cribriform carcinoma had better DRFI (5-year rates 97.8% and 98.8%, respectively) than those with ductal (90.9%) or other (92.1%) carcinomas. Within the subgroup of women with special histotypes, we observed a nonsignificant increase in the hazard of breast cancer recurrence with letrozole [hazard (letrozole versus tamoxifen): 3.31, 95% confidence interval 0.94-11.7; P = 0.06].

CONCLUSIONS: Women with mucinous or tubular/cribriform breast cancer have better outcomes than those with other histotypes, although the observation is based on a limited number of events. In postmenopausal women with these histotypes, the magnitude of the letrozole advantage compared with tamoxifen may not be as large in patients with mucinous or tubular/cribriform disease.

CLINICALTRIALSGOV: NCT00004205.

OriginalsprogEngelsk
TidsskriftAnnals of oncology : official journal of the European Society for Medical Oncology / ESMO
Vol/bind26
Udgave nummer12
Sider (fra-til)2442-9
Antal sider8
ISSN0923-7534
DOI
StatusUdgivet - dec. 2015

ID: 45951791