Outcomes of special histotypes of breast cancer after adjuvant endocrine therapy with letrozole or tamoxifen in the monotherapy cohort of the BIG 1-98 trial

E. Munzone, A. Giobbie-Hurder, B. A. Gusterson, E. Mallon, G. Viale, B. Thürlimann, B. Ejlertsen, G. MacGrogan, F. Bibeau, G. Lelkaitis, N. Price, R. D. Gelber, A. S. Coates, A. Goldhirsch, M. Colleoni

Research output: Contribution to journalArticle

Abstract

Background: We investigated the outcomes of postmenopausal women with hormone receptor-positive, early breast cancer with special histotypes (mucinous, tubular, or cribriform) enrolled in the monotherapy cohort of the BIG 1-98 trial. Patients and methods: The intention-to-treat BIG 1-98 monotherapy cohort (5 years of therapy with tamoxifen or letrozole) included 4922 women, of whom 4091 had central pathology review. Histotype groups were defined as: mucinous (N = 100), tubular/cribriform (N = 83), ductal (N = 3257), and other (N = 651). Of 183 women with either mucinous or tubular/cribriform tumors, 96 were randomly assigned to letrozole and 87 to tamoxifen. Outcomes assessed were disease-free survival (DFS), overall survival (OS), breast cancer-free interval (BCFI), and distant recurrence-free interval (DRFI). Median follow-up in the analytic cohort was 8.1 years. Results: Women with tubular/cribriform breast cancer had the best outcomes for all end points compared with the other three histotypes, and had less breast cancer recurrence (97.5% 5-year BCFI) than those with mucinous (93.5%), ductal (88.9%), or other (89.9%) histotypes. Patients with mucinous or tubular/cribriform carcinoma had better DRFI (5-year rates 97.8% and 98.8%, respectively) than those with ductal (90.9%) or other (92.1%) carcinomas. Within the subgroup of women with special histotypes, we observed a nonsignificant increase in the hazard of breast cancer recurrence with letrozole [hazard (letrozole versus tamoxifen): 3.31, 95% confidence interval 0.94-11.7; P = 0.06]. Conclusions: Women with mucinous or tubular/cribriform breast cancer have better outcomes than those with other histotypes, although the observation is based on a limited number of events. In postmenopausal women with these histotypes, the magnitude of the letrozole advantage compared with tamoxifen may not be as large in patients with mucinous or tubular/cribriform disease.

Original languageEnglish
Pages (from-to)2442-2449
Number of pages8
JournalAnnals of Oncology
Volume26
Issue number12
DOIs
Publication statusPublished - Dec 1 2015

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letrozole
Tamoxifen
Breast Neoplasms
Recurrence
Therapeutics
Adenocarcinoma
Disease-Free Survival

Keywords

  • Breast cancer
  • cribriform
  • Letrozole
  • Mucinous
  • Tamoxifen
  • Tubular

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Outcomes of special histotypes of breast cancer after adjuvant endocrine therapy with letrozole or tamoxifen in the monotherapy cohort of the BIG 1-98 trial. / Munzone, E.; Giobbie-Hurder, A.; Gusterson, B. A.; Mallon, E.; Viale, G.; Thürlimann, B.; Ejlertsen, B.; MacGrogan, G.; Bibeau, F.; Lelkaitis, G.; Price, N.; Gelber, R. D.; Coates, A. S.; Goldhirsch, A.; Colleoni, M.

In: Annals of Oncology, Vol. 26, No. 12, 01.12.2015, p. 2442-2449.

Research output: Contribution to journalArticle

Munzone, E, Giobbie-Hurder, A, Gusterson, BA, Mallon, E, Viale, G, Thürlimann, B, Ejlertsen, B, MacGrogan, G, Bibeau, F, Lelkaitis, G, Price, N, Gelber, RD, Coates, AS, Goldhirsch, A & Colleoni, M 2015, 'Outcomes of special histotypes of breast cancer after adjuvant endocrine therapy with letrozole or tamoxifen in the monotherapy cohort of the BIG 1-98 trial', Annals of Oncology, vol. 26, no. 12, pp. 2442-2449. https://doi.org/10.1093/annonc/mdv391
Munzone, E. ; Giobbie-Hurder, A. ; Gusterson, B. A. ; Mallon, E. ; Viale, G. ; Thürlimann, B. ; Ejlertsen, B. ; MacGrogan, G. ; Bibeau, F. ; Lelkaitis, G. ; Price, N. ; Gelber, R. D. ; Coates, A. S. ; Goldhirsch, A. ; Colleoni, M. / Outcomes of special histotypes of breast cancer after adjuvant endocrine therapy with letrozole or tamoxifen in the monotherapy cohort of the BIG 1-98 trial. In: Annals of Oncology. 2015 ; Vol. 26, No. 12. pp. 2442-2449.
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abstract = "Background: We investigated the outcomes of postmenopausal women with hormone receptor-positive, early breast cancer with special histotypes (mucinous, tubular, or cribriform) enrolled in the monotherapy cohort of the BIG 1-98 trial. Patients and methods: The intention-to-treat BIG 1-98 monotherapy cohort (5 years of therapy with tamoxifen or letrozole) included 4922 women, of whom 4091 had central pathology review. Histotype groups were defined as: mucinous (N = 100), tubular/cribriform (N = 83), ductal (N = 3257), and other (N = 651). Of 183 women with either mucinous or tubular/cribriform tumors, 96 were randomly assigned to letrozole and 87 to tamoxifen. Outcomes assessed were disease-free survival (DFS), overall survival (OS), breast cancer-free interval (BCFI), and distant recurrence-free interval (DRFI). Median follow-up in the analytic cohort was 8.1 years. Results: Women with tubular/cribriform breast cancer had the best outcomes for all end points compared with the other three histotypes, and had less breast cancer recurrence (97.5{\%} 5-year BCFI) than those with mucinous (93.5{\%}), ductal (88.9{\%}), or other (89.9{\%}) histotypes. Patients with mucinous or tubular/cribriform carcinoma had better DRFI (5-year rates 97.8{\%} and 98.8{\%}, respectively) than those with ductal (90.9{\%}) or other (92.1{\%}) carcinomas. Within the subgroup of women with special histotypes, we observed a nonsignificant increase in the hazard of breast cancer recurrence with letrozole [hazard (letrozole versus tamoxifen): 3.31, 95{\%} confidence interval 0.94-11.7; P = 0.06]. Conclusions: Women with mucinous or tubular/cribriform breast cancer have better outcomes than those with other histotypes, although the observation is based on a limited number of events. In postmenopausal women with these histotypes, the magnitude of the letrozole advantage compared with tamoxifen may not be as large in patients with mucinous or tubular/cribriform disease.",
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T1 - Outcomes of special histotypes of breast cancer after adjuvant endocrine therapy with letrozole or tamoxifen in the monotherapy cohort of the BIG 1-98 trial

AU - Munzone, E.

AU - Giobbie-Hurder, A.

AU - Gusterson, B. A.

AU - Mallon, E.

AU - Viale, G.

AU - Thürlimann, B.

AU - Ejlertsen, B.

AU - MacGrogan, G.

AU - Bibeau, F.

AU - Lelkaitis, G.

AU - Price, N.

AU - Gelber, R. D.

AU - Coates, A. S.

AU - Goldhirsch, A.

AU - Colleoni, M.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Background: We investigated the outcomes of postmenopausal women with hormone receptor-positive, early breast cancer with special histotypes (mucinous, tubular, or cribriform) enrolled in the monotherapy cohort of the BIG 1-98 trial. Patients and methods: The intention-to-treat BIG 1-98 monotherapy cohort (5 years of therapy with tamoxifen or letrozole) included 4922 women, of whom 4091 had central pathology review. Histotype groups were defined as: mucinous (N = 100), tubular/cribriform (N = 83), ductal (N = 3257), and other (N = 651). Of 183 women with either mucinous or tubular/cribriform tumors, 96 were randomly assigned to letrozole and 87 to tamoxifen. Outcomes assessed were disease-free survival (DFS), overall survival (OS), breast cancer-free interval (BCFI), and distant recurrence-free interval (DRFI). Median follow-up in the analytic cohort was 8.1 years. Results: Women with tubular/cribriform breast cancer had the best outcomes for all end points compared with the other three histotypes, and had less breast cancer recurrence (97.5% 5-year BCFI) than those with mucinous (93.5%), ductal (88.9%), or other (89.9%) histotypes. Patients with mucinous or tubular/cribriform carcinoma had better DRFI (5-year rates 97.8% and 98.8%, respectively) than those with ductal (90.9%) or other (92.1%) carcinomas. Within the subgroup of women with special histotypes, we observed a nonsignificant increase in the hazard of breast cancer recurrence with letrozole [hazard (letrozole versus tamoxifen): 3.31, 95% confidence interval 0.94-11.7; P = 0.06]. Conclusions: Women with mucinous or tubular/cribriform breast cancer have better outcomes than those with other histotypes, although the observation is based on a limited number of events. In postmenopausal women with these histotypes, the magnitude of the letrozole advantage compared with tamoxifen may not be as large in patients with mucinous or tubular/cribriform disease.

AB - Background: We investigated the outcomes of postmenopausal women with hormone receptor-positive, early breast cancer with special histotypes (mucinous, tubular, or cribriform) enrolled in the monotherapy cohort of the BIG 1-98 trial. Patients and methods: The intention-to-treat BIG 1-98 monotherapy cohort (5 years of therapy with tamoxifen or letrozole) included 4922 women, of whom 4091 had central pathology review. Histotype groups were defined as: mucinous (N = 100), tubular/cribriform (N = 83), ductal (N = 3257), and other (N = 651). Of 183 women with either mucinous or tubular/cribriform tumors, 96 were randomly assigned to letrozole and 87 to tamoxifen. Outcomes assessed were disease-free survival (DFS), overall survival (OS), breast cancer-free interval (BCFI), and distant recurrence-free interval (DRFI). Median follow-up in the analytic cohort was 8.1 years. Results: Women with tubular/cribriform breast cancer had the best outcomes for all end points compared with the other three histotypes, and had less breast cancer recurrence (97.5% 5-year BCFI) than those with mucinous (93.5%), ductal (88.9%), or other (89.9%) histotypes. Patients with mucinous or tubular/cribriform carcinoma had better DRFI (5-year rates 97.8% and 98.8%, respectively) than those with ductal (90.9%) or other (92.1%) carcinomas. Within the subgroup of women with special histotypes, we observed a nonsignificant increase in the hazard of breast cancer recurrence with letrozole [hazard (letrozole versus tamoxifen): 3.31, 95% confidence interval 0.94-11.7; P = 0.06]. Conclusions: Women with mucinous or tubular/cribriform breast cancer have better outcomes than those with other histotypes, although the observation is based on a limited number of events. In postmenopausal women with these histotypes, the magnitude of the letrozole advantage compared with tamoxifen may not be as large in patients with mucinous or tubular/cribriform disease.

KW - Breast cancer

KW - cribriform

KW - Letrozole

KW - Mucinous

KW - Tamoxifen

KW - Tubular

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