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dc.contributor.authorMauriac, Louis
dc.contributor.authorKeshaviah, Aparna
dc.contributor.authorDebled, M
dc.contributor.authorMouridsen, Henning
dc.contributor.authorForbes, John F
dc.contributor.authorThürlimann, Beat
dc.contributor.authorParidaens, Robert
dc.contributor.authorMonnier, A
dc.contributor.authorLáng, I
dc.contributor.authorWardley, Andrew M
dc.contributor.authorNogaret, Jean-Marie
dc.contributor.authorGelber, Richard D
dc.contributor.authorCastiglione-Gertsch, Monica
dc.contributor.authorPrice, Karen N
dc.contributor.authorCoates, Alan S
dc.contributor.authorSmith, Ian
dc.contributor.authorViale, G
dc.contributor.authorRabaglio, Manuela
dc.contributor.authorZabaznyi, N
dc.contributor.authorGoldhirsch, Aron
dc.date.accessioned2009-06-30T14:25:59Z
dc.date.available2009-06-30T14:25:59Z
dc.date.issued2007-05
dc.identifier.citationPredictors of early relapse in postmenopausal women with hormone receptor-positive breast cancer in the BIG 1-98 trial. 2007, 18 (5):859-67 Ann. Oncol.en
dc.identifier.issn0923-7534
dc.identifier.pmid17301074
dc.identifier.doi10.1093/annonc/mdm001
dc.identifier.urihttp://hdl.handle.net/10541/71963
dc.description.abstractBACKGROUND: Aromatase inhibitors are considered standard adjuvant endocrine treatment of postmenopausal women with hormone receptor-positive breast cancer, but it remains uncertain whether aromatase inhibitors should be given upfront or sequentially with tamoxifen. Awaiting results from ongoing randomized trials, we examined prognostic factors of an early relapse among patients in the BIG 1-98 trial to aid in treatment choices. PATIENTS AND METHODS: Analyses included all 7707 eligible patients treated on BIG 1-98. The median follow-up was 2 years, and the primary end point was breast cancer relapse. Cox proportional hazards regression was used to identify prognostic factors. RESULTS: Two hundred and eighty-five patients (3.7%) had an early relapse (3.1% on letrozole, 4.4% on tamoxifen). Predictive factors for early relapse were node positivity (P < 0.001), absence of both receptors being positive (P < 0.001), high tumor grade (P < 0.001), HER-2 overexpression/amplification (P < 0.001), large tumor size (P = 0.001), treatment with tamoxifen (P = 0.002), and vascular invasion (P = 0.02). There were no significant interactions between treatment and the covariates, though letrozole appeared to provide a greater than average reduction in the risk of early relapse in patients with many involved lymph nodes, large tumors, and vascular invasion present. CONCLUSION: Upfront letrozole resulted in significantly fewer early relapses than tamoxifen, even after adjusting for significant prognostic factors.
dc.language.isoenen
dc.subjectBreast Canceren
dc.subjectCancer Recurrenceen
dc.subject.meshAntineoplastic Agents, Hormonal
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols
dc.subject.meshAromatase Inhibitors
dc.subject.meshBreast Neoplasms
dc.subject.meshChemotherapy, Adjuvant
dc.subject.meshDisease-Free Survival
dc.subject.meshFemale
dc.subject.meshFollow-Up Studies
dc.subject.meshHumans
dc.subject.meshMiddle Aged
dc.subject.meshNeoplasm Recurrence, Local
dc.subject.meshNeoplasms, Hormone-Dependent
dc.subject.meshNitriles
dc.subject.meshPostmenopause
dc.subject.meshPrognosis
dc.subject.meshTamoxifen
dc.subject.meshTime Factors
dc.subject.meshTreatment Outcome
dc.subject.meshTriazoles
dc.titlePredictors of early relapse in postmenopausal women with hormone receptor-positive breast cancer in the BIG 1-98 trial.en
dc.typeArticleen
dc.contributor.departmentFrench Breast Cancer Group, Institut Bergonié Bordeaux, France. mauriac@bergonie.orgen
dc.identifier.journalAnnals of Oncologyen
refterms.dateFOA2020-04-20T14:32:22Z
html.description.abstractBACKGROUND: Aromatase inhibitors are considered standard adjuvant endocrine treatment of postmenopausal women with hormone receptor-positive breast cancer, but it remains uncertain whether aromatase inhibitors should be given upfront or sequentially with tamoxifen. Awaiting results from ongoing randomized trials, we examined prognostic factors of an early relapse among patients in the BIG 1-98 trial to aid in treatment choices. PATIENTS AND METHODS: Analyses included all 7707 eligible patients treated on BIG 1-98. The median follow-up was 2 years, and the primary end point was breast cancer relapse. Cox proportional hazards regression was used to identify prognostic factors. RESULTS: Two hundred and eighty-five patients (3.7%) had an early relapse (3.1% on letrozole, 4.4% on tamoxifen). Predictive factors for early relapse were node positivity (P < 0.001), absence of both receptors being positive (P < 0.001), high tumor grade (P < 0.001), HER-2 overexpression/amplification (P < 0.001), large tumor size (P = 0.001), treatment with tamoxifen (P = 0.002), and vascular invasion (P = 0.02). There were no significant interactions between treatment and the covariates, though letrozole appeared to provide a greater than average reduction in the risk of early relapse in patients with many involved lymph nodes, large tumors, and vascular invasion present. CONCLUSION: Upfront letrozole resulted in significantly fewer early relapses than tamoxifen, even after adjusting for significant prognostic factors.


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