TY - JOUR
T1 - Efficacy of anastrozole after tamoxifen in early breast cancer patients with chemotherapy-induced ovarian function failure
AU - van Hellemond, Irene E. G.
AU - Vriens, Ingeborg J. H.
AU - Peer, Petronella G. M.
AU - Swinkels, Astrid C. P.
AU - Smorenburg, Carolien H.
AU - Seynaeve, Caroline M.
AU - van der Sangen, Maurice J. C.
AU - Kroep, Judith R.
AU - de Graaf, Hiltje
AU - Honkoop, Aafke H.
AU - Erdkamp, Frans L. G.
AU - van den Berkmortel, Franchette W. Pj
AU - de Boer, Maaike
AU - de Roos, Wilfred K.
AU - Linn, Sabine C.
AU - Imholz, Alexander L. T.
AU - Tjan-Heijnen, Vivianne C. G.
AU - Dutch Breast Canc Res Grp BOOG
N1 - Funding Information:
The authors thank W. Lemmens and B. Schalk for their assistance with performing the statistical analyses. Disclosures: I.E.G. van Hellemond and A.C.P. Swinkels received a research grant from AstraZeneca. M. de Boer received research grants from Roche, Novartis, Eisai, AstraZeneca and Pfizer. S.C. Linn reports advisory board membership for TBM Health, Novartis and Pfizer, and institutional unrestricted research grant and studying support from AstraZeneca, Roche, Genentech and Tesaro. V.C.G. Tjan-Heijnen received research grants from AstraZeneca, Novartis, Pfizer, Roche, Lily and Eisai. Honorarium for lectures: Roche, Novartis, Pfizer and Lily. The other authors have no conflicts of interest to declare.
Funding Information:
Disclosures: I.E.G. van Hellemond and A.C.P. Swinkels received a research grant from AstraZeneca. M. de Boer received research grants from Roche, Novartis, Eisai, AstraZeneca and Pfizer. S.C. Linn reports advisory board membership for TBM Health, Novartis and Pfizer, and institutional unrestricted research grant and studying support from Astra-Zeneca, Roche, Genentech and Tesaro. V.C.G. Tjan-Heijnen received research grants from AstraZeneca, Novartis, Pfizer, Roche, Lily and Eisai.
Publisher Copyright:
© 2018 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC
PY - 2019/7/1
Y1 - 2019/7/1
N2 - The DATA study (NCT00301457) compared 6 and 3 years of anastrozole in postmenopausal women with hormone receptor-positive early breast cancer after 2-3 years of tamoxifen. Patients with chemotherapy-induced ovarian function failure (CIOFF) were also eligible, but could be at risk of ovarian function recovery (OFR). The current analysis compared the survival of women with CIOFF with definitely postmenopausal women and examined the influence of OFR on survival. Therefore, we selected patients from the DATA study aged 45-57 years at randomization who had received (neo)adjuvant chemotherapy. They were classified by reversibility of postmenopausal status: possibly reversible in case of CIOFF (n = 395) versus definitely postmenopausal (n = 261). The former were monitored by E2 measurements for OFR. The occurrence of OFR was incorporated as a time-dependent covariate in a Cox-regression model for calculating the hazard ratio (HR). We used the landmark method to calculate residual 5-year survival rates. When comparing CIOFF women with definitely postmenopausal women, the survival was not different. Among CIOFF women with available E2 follow-up values (n = 329), experiencing OFR (n = 39) had an unfavorable impact on distant recurrence-free survival (HR 2.27 [95% confidence interval [CI] 0.98-5.25; p = 0.05] and overall survival (HR 2.61 [95% CI 1.11-6.13; p = 0.03]). After adjusting for tumor features, the HRs became 2.11 (95% CI 0.89-5.02; p = 0.09) and 2.24 (95% CI 0.92-5.45; p = 0.07), respectively. The residual 5-year rate for distant recurrence-free survival was 76.9% for women with OFR and 92.1% for women without OFR, and for 5-year overall survival 80.8% and 94.4%, respectively. Women with CIOFF receiving anastrozole may be at increased risk of disease recurrence if experiencing OFR.
AB - The DATA study (NCT00301457) compared 6 and 3 years of anastrozole in postmenopausal women with hormone receptor-positive early breast cancer after 2-3 years of tamoxifen. Patients with chemotherapy-induced ovarian function failure (CIOFF) were also eligible, but could be at risk of ovarian function recovery (OFR). The current analysis compared the survival of women with CIOFF with definitely postmenopausal women and examined the influence of OFR on survival. Therefore, we selected patients from the DATA study aged 45-57 years at randomization who had received (neo)adjuvant chemotherapy. They were classified by reversibility of postmenopausal status: possibly reversible in case of CIOFF (n = 395) versus definitely postmenopausal (n = 261). The former were monitored by E2 measurements for OFR. The occurrence of OFR was incorporated as a time-dependent covariate in a Cox-regression model for calculating the hazard ratio (HR). We used the landmark method to calculate residual 5-year survival rates. When comparing CIOFF women with definitely postmenopausal women, the survival was not different. Among CIOFF women with available E2 follow-up values (n = 329), experiencing OFR (n = 39) had an unfavorable impact on distant recurrence-free survival (HR 2.27 [95% confidence interval [CI] 0.98-5.25; p = 0.05] and overall survival (HR 2.61 [95% CI 1.11-6.13; p = 0.03]). After adjusting for tumor features, the HRs became 2.11 (95% CI 0.89-5.02; p = 0.09) and 2.24 (95% CI 0.92-5.45; p = 0.07), respectively. The residual 5-year rate for distant recurrence-free survival was 76.9% for women with OFR and 92.1% for women without OFR, and for 5-year overall survival 80.8% and 94.4%, respectively. Women with CIOFF receiving anastrozole may be at increased risk of disease recurrence if experiencing OFR.
KW - breast cancer
KW - aromatase inhibitor
KW - chemotherapy-induced amenorrhea
KW - chemotherapy-induced ovarian function failure (CIOFF)
KW - ovarian function recovery (OFR)
KW - ADJUVANT ENDOCRINE THERAPY
KW - BODY-MASS INDEX
KW - AROMATASE INHIBITORS
KW - POSTMENOPAUSAL WOMEN
KW - PREMENOPAUSAL PATIENTS
KW - LEVEL METAANALYSIS
KW - LETROZOLE
KW - EXEMESTANE
KW - AMENORRHEA
KW - ESTRADIOL
U2 - 10.1002/ijc.32093
DO - 10.1002/ijc.32093
M3 - Article
C2 - 30588619
SN - 0020-7136
VL - 145
SP - 274
EP - 283
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 1
ER -