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Rigshospitalet - en del af Københavns Universitetshospital
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Relative Effectiveness of Letrozole Compared With Tamoxifen for Patients With Lobular Carcinoma in the BIG 1-98 Trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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  • Otto Metzger Filho
  • Anita Giobbie-Hurder
  • Elizabeth Mallon
  • Barry Gusterson
  • Giuseppe Viale
  • Eric P Winer
  • Beat Thürlimann
  • Richard D Gelber
  • Marco Colleoni
  • Bent Ejlertsen
  • Marc Debled
  • Karen N Price
  • Meredith M Regan
  • Alan S Coates
  • Aron Goldhirsch
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PURPOSE: To evaluate the relative effectiveness of letrozole compared with tamoxifen for patients with invasive ductal or lobular carcinoma.

PATIENTS AND METHODS: Patients diagnosed with early-stage invasive ductal carcinoma (IDC) or classic invasive lobular carcinoma (ILC) who were randomly assigned onto the Breast International Group (BIG) 1-98 trial and who had centrally reviewed pathology data were included (N = 2,923). HER2-negative IDC and ILC were additionally classified as hormone receptor-positive with high (luminal B [LB] -like) or low (luminal A [LA] -like) proliferative activity by Ki-67 labeling index. Survival analyses were performed with weighted Cox models that used inverse probability of censoring weighted modeling.

RESULTS: The median follow-up time was 8.1 years. In multivariable models for disease-free survival (DFS), significant interactions between treatment and histology (ILC or IDC; P = .006) and treatment and subgroup (LB like or LA like; P = .01) were observed. In the ILC subset, there was a 66% reduction in the hazard of a DFS event with letrozole for LB (hazard ratio [HR], 0.34; 95% CI, 0.21 to 0.55) and a 50% reduction for LA subtypes (HR, 0.50; 95% CI, 0.32 to 0.78). In the IDC subset, there was a significant 35% reduction in the hazard of a DFS event with letrozole for the LB subtype (HR, 0.65; 95% CI, 0.53 to 0.79), but no difference between treatments was noted for IDC and the LA subtype (HR, 0.95; 95% CI, 0.76 to 1.20).

CONCLUSION: The magnitude of benefit of adjuvant letrozole is greater for patients diagnosed with lobular carcinoma versus ductal carcinoma.

OriginalsprogEngelsk
TidsskriftJournal of clinical oncology : official journal of the American Society of Clinical Oncology
Vol/bind33
Udgave nummer25
Sider (fra-til)2772-9
Antal sider8
ISSN0732-183X
DOI
StatusUdgivet - 1 sep. 2015

ID: 45951842