Abstract
PURPOSE: To determine the relationship between quantitative estrogen-receptor (ER) and progesterone-receptor (PgR) expression and human epidermal growth factor 2 (HER-2) status with time to recurrence (TTR) in postmenopausal women with hormone receptor-positive primary breast cancer treated with anastrozole or tamoxifen as adjuvant therapy.
PATIENTS AND METHODS: Formalin-fixed, paraffin-embedded tumor blocks were retrospectively collected from patients in the monotherapy arms of the Arimidex, Tamoxifen Alone or in Combination (ATAC) trial and centrally tested for ER, PgR and HER-2. ER and PgR were scored using continuous scales and HER-2 was scored as 0 to 3+ with 2+ cases being analyzed by fluorescence in situ hybridization.
RESULTS: Blocks were collected from 2,006 of 5,880 eligible patients. Tissue was assessable and ER and/or PgR positivity confirmed centrally in 1,782 cases. In these, TTR was longer for anastrozole than for tamoxifen by a similar extent to that in the overall trial. None of the three biomarkers identified a set of patients with differential benefit from anastrozole over tamoxifen. Patients with low ER, low PgR, and high HER-2 expression had a poorer prognosis with either drug. Only 2.6% of patients in the highest quartile of PgR experienced recurrence after 5 years, compared with 13.2% in the lowest quartile.
CONCLUSION: Quantitative expression of ER and PgR and HER-2 status did not identify patients with differential relative benefit from anastrozole over tamoxifen: TTR was longer for anastrozole than for tamoxifen in all molecular subgroups. Low ER or PgR or high HER-2 expression are associated with a high risk of recurrence with either anastrozole or tamoxifen.
Original language | English |
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Pages (from-to) | 1059-65 |
Number of pages | 7 |
Journal | Journal of Clinical Oncology |
Volume | 26 |
Issue number | 7 |
DOIs | |
Publication status | Published - 1 Mar 2008 |
Externally published | Yes |
Keywords
- Antineoplastic Combined Chemotherapy Protocols
- Breast Neoplasms
- Chemotherapy, Adjuvant
- Double-Blind Method
- Female
- Humans
- Middle Aged
- Neoplasm Recurrence, Local
- Nitriles
- Postmenopause
- Prognosis
- Receptor, ErbB-2
- Receptors, Estrogen
- Receptors, Progesterone
- Retrospective Studies
- Survival Rate
- Tamoxifen
- Time Factors
- Tissue Array Analysis
- Treatment Outcome
- Triazoles
- Journal Article
- Randomized Controlled Trial