Composite risk and benefit from adjuvant dose-dense chemotherapy in hormone receptor-positive breast cancer

Fabio Puglisi, Lorenzo Gerratana, Matteo Lambertini, Marcello Ceppi, Luca Boni, Filippo Montemurro, Stefania Russo, Claudia Bighin, Michelino De Laurentiis, Mario Giuliano, Giancarlo Bisagni, Antonio Durando, Anna Turletti, Ornella Garrone, Andrea Ardizzoni, Teresa Gamucci, Giuseppe Colantuoni, Adriano Gravina, Sabino De Placido, Francesco CognettiLucia Del Mastro

Research output: Contribution to journalArticlepeer-review

Abstract

The GIM2 phase III trial demonstrated the benefit of dose-dense chemotherapy in node-positive early breast cancer (eBC). To better define the dose-dense effect in the hormone receptor-positive subgroup, we evaluated its benefit through a composite measure of recurrence risk. We conducted an ancillary analysis of the GIM2 trial evaluating the absolute treatment effect through a composite measure of recurrence risk (CPRS) in patients with hormone receptor-positive HER2-negative eBC. CPRS was estimated through Cox proportional hazards models applied to the different clinicopathological features. The treatment effect was compared to the values of CPRS by using the Sub-population Treatment Effect Pattern Plot (STEPP) process. The Disease-Free Survival (DFS)-oriented STEPP analysis showed distinct patterns of relative treatment effect with respect to CPRS. Overall, 5-year DFS differed across CPRS quartiles ranging from 95.2 to 66.4%. Each CPRS quartile was characterized by a different patients' composition, especially for age, lymph node involvement, tumor size, estrogen and progesterone receptor expression, and Ki-67. A number needed to treat of 154 and 6 was associated with the lowest and the highest CPRS quartile, respectively. Dose-dense adjuvant chemotherapy showed a consistent benefit in node-positive eBC patients with hormone receptor-positive HER2-negative disease, but its effect varied according to CPRS.

Original languageEnglish
Pages (from-to)82
Journalnpj Breast Cancer
Volume7
Issue number1
DOIs
Publication statusPublished - Jun 28 2021

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