Clinical outcome of adjuvant endocrine treatment according to PR and HER-2 status in early breast cancer

R. Ponzone, F. Montemurro, F. Maggiorotto, C. Robba, D. Gregori, M. E. Jacomuzzi, F. Kubatzki, D. Marenco, A. Dominguez, N. Biglia, P. Sismondi

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Abstract

Patients with estrogen receptor (ER)+/progesterone receptor (PR)- and/or HER-2 overexpressing breast carcinomas may derive lower benefit from endocrine treatment. We examined retrospectively data from 972 breast cancer patients who received tamoxifen (725), tamoxifen + Gn-RH analogs (127) and aromatase inhibitors (120) as adjuvant treatments. ER+/PR- versus ER+/PR+ tumours were characterised by larger size (P = 0.001), higher tumour grade (P = 0.001), higher Ki-67 expression (P = 0.001) and lower mean ER (P = 0.000) and HER-2 expression (P = 0.000). At univariate analysis, tumour grading [hazard ratio (HR) = 4.0; 95% confidence interval (CI) = 1.4-11.1; P = 0.007], nodal status (HR = 3.4; 95% CI 1.2-5.7; P = 0.000), tumour diameter (HR = 2.9; 95% CI 1.7-4.7; P = 0.000) lack of PR expression (HR = 2.1; 95% CI 1.3-3.4; P = 0.002) and HER-2 overexpression (HR = 1.9; 95% CI 1.0-3.5; P = 0.03), as well as Ki 67 expression (HR = 1.7; 95% CI 1.0-2.7; P = 0.04) were associated with shorter disease-free survival (DFS). At the multivariate analysis, nodal status (HR = 3.6; 95% CI 1.9-6.8; P = 0.0001), lack of PR expression (HR = 2.3; 95% CI 1.3-4.0; P = 0.003) and tumour diameter (HR = 2.1; 95% CI 1.1-3.8; P = 0.018) retained their prognostic significance, whereas HER-2 overexpression was associated with a trend towards shorter DFS that was of borderline statistical significance (HR = 2.0; 95 % CI 1.0-3.9; P = 0.05). Our data suggest that lack of PR expression and HER-2 overexpression are both associated with aggressive tumour features, but the prognostic information of PR status on the risk of recurrence in endocrine-treated breast cancer patients is stronger.

Original languageEnglish
Pages (from-to)1631-1636
Number of pages6
JournalAnnals of Oncology
Volume17
Issue number11
DOIs
Publication statusPublished - Nov 2006

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Progesterone Receptors
Confidence Intervals
Breast Neoplasms
Estrogen Receptors
Therapeutics
Tamoxifen
Neoplasms
Disease-Free Survival
Aromatase Inhibitors
Neoplasm Grading
Gonadotropin-Releasing Hormone
Multivariate Analysis
Recurrence

Keywords

  • Adjuvant
  • Breast neoplasm
  • Endocrine therapy
  • Estrogen receptor
  • HER-2
  • Progesterone receptor

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Clinical outcome of adjuvant endocrine treatment according to PR and HER-2 status in early breast cancer. / Ponzone, R.; Montemurro, F.; Maggiorotto, F.; Robba, C.; Gregori, D.; Jacomuzzi, M. E.; Kubatzki, F.; Marenco, D.; Dominguez, A.; Biglia, N.; Sismondi, P.

In: Annals of Oncology, Vol. 17, No. 11, 11.2006, p. 1631-1636.

Research output: Contribution to journalArticle

Ponzone, R. ; Montemurro, F. ; Maggiorotto, F. ; Robba, C. ; Gregori, D. ; Jacomuzzi, M. E. ; Kubatzki, F. ; Marenco, D. ; Dominguez, A. ; Biglia, N. ; Sismondi, P. / Clinical outcome of adjuvant endocrine treatment according to PR and HER-2 status in early breast cancer. In: Annals of Oncology. 2006 ; Vol. 17, No. 11. pp. 1631-1636.
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abstract = "Patients with estrogen receptor (ER)+/progesterone receptor (PR)- and/or HER-2 overexpressing breast carcinomas may derive lower benefit from endocrine treatment. We examined retrospectively data from 972 breast cancer patients who received tamoxifen (725), tamoxifen + Gn-RH analogs (127) and aromatase inhibitors (120) as adjuvant treatments. ER+/PR- versus ER+/PR+ tumours were characterised by larger size (P = 0.001), higher tumour grade (P = 0.001), higher Ki-67 expression (P = 0.001) and lower mean ER (P = 0.000) and HER-2 expression (P = 0.000). At univariate analysis, tumour grading [hazard ratio (HR) = 4.0; 95{\%} confidence interval (CI) = 1.4-11.1; P = 0.007], nodal status (HR = 3.4; 95{\%} CI 1.2-5.7; P = 0.000), tumour diameter (HR = 2.9; 95{\%} CI 1.7-4.7; P = 0.000) lack of PR expression (HR = 2.1; 95{\%} CI 1.3-3.4; P = 0.002) and HER-2 overexpression (HR = 1.9; 95{\%} CI 1.0-3.5; P = 0.03), as well as Ki 67 expression (HR = 1.7; 95{\%} CI 1.0-2.7; P = 0.04) were associated with shorter disease-free survival (DFS). At the multivariate analysis, nodal status (HR = 3.6; 95{\%} CI 1.9-6.8; P = 0.0001), lack of PR expression (HR = 2.3; 95{\%} CI 1.3-4.0; P = 0.003) and tumour diameter (HR = 2.1; 95{\%} CI 1.1-3.8; P = 0.018) retained their prognostic significance, whereas HER-2 overexpression was associated with a trend towards shorter DFS that was of borderline statistical significance (HR = 2.0; 95 {\%} CI 1.0-3.9; P = 0.05). Our data suggest that lack of PR expression and HER-2 overexpression are both associated with aggressive tumour features, but the prognostic information of PR status on the risk of recurrence in endocrine-treated breast cancer patients is stronger.",
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AU - Ponzone, R.

AU - Montemurro, F.

AU - Maggiorotto, F.

AU - Robba, C.

AU - Gregori, D.

AU - Jacomuzzi, M. E.

AU - Kubatzki, F.

AU - Marenco, D.

AU - Dominguez, A.

AU - Biglia, N.

AU - Sismondi, P.

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N2 - Patients with estrogen receptor (ER)+/progesterone receptor (PR)- and/or HER-2 overexpressing breast carcinomas may derive lower benefit from endocrine treatment. We examined retrospectively data from 972 breast cancer patients who received tamoxifen (725), tamoxifen + Gn-RH analogs (127) and aromatase inhibitors (120) as adjuvant treatments. ER+/PR- versus ER+/PR+ tumours were characterised by larger size (P = 0.001), higher tumour grade (P = 0.001), higher Ki-67 expression (P = 0.001) and lower mean ER (P = 0.000) and HER-2 expression (P = 0.000). At univariate analysis, tumour grading [hazard ratio (HR) = 4.0; 95% confidence interval (CI) = 1.4-11.1; P = 0.007], nodal status (HR = 3.4; 95% CI 1.2-5.7; P = 0.000), tumour diameter (HR = 2.9; 95% CI 1.7-4.7; P = 0.000) lack of PR expression (HR = 2.1; 95% CI 1.3-3.4; P = 0.002) and HER-2 overexpression (HR = 1.9; 95% CI 1.0-3.5; P = 0.03), as well as Ki 67 expression (HR = 1.7; 95% CI 1.0-2.7; P = 0.04) were associated with shorter disease-free survival (DFS). At the multivariate analysis, nodal status (HR = 3.6; 95% CI 1.9-6.8; P = 0.0001), lack of PR expression (HR = 2.3; 95% CI 1.3-4.0; P = 0.003) and tumour diameter (HR = 2.1; 95% CI 1.1-3.8; P = 0.018) retained their prognostic significance, whereas HER-2 overexpression was associated with a trend towards shorter DFS that was of borderline statistical significance (HR = 2.0; 95 % CI 1.0-3.9; P = 0.05). Our data suggest that lack of PR expression and HER-2 overexpression are both associated with aggressive tumour features, but the prognostic information of PR status on the risk of recurrence in endocrine-treated breast cancer patients is stronger.

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