Real-world utilization of aromatase inhibitors, tamoxifen, and ovarian function suppression in premenopausal patients with early hormone receptor-positive, HER2-negative breast cancer with increased recurrence risk

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Pub Date : 2025-03-22 DOI:10.1016/j.breast.2025.104458

Volkmar Müller , Manuel Hörner , Marc Thill , Maggie Banys-Paluchowski , Sabine Schmatloch , Peter A. Fasching , Nadia Harbeck , Dagmar Langanke , Sabrina Uhrig , Lothar Häberle , Dorothea Fischer , Alexander Hein , Tanja N. Fehm , Chloë Goossens , Jürgen Terhaag , Uwe Heilenkötter , Peter Dall , Christian Rudlowski , Rachel Wuerstlein , Mustafa Aydogdu , Andreas D. Hartkopf

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引用次数: 0

Abstract

Background

The optimal adjuvant endocrine treatment in premenopausal patients with hormone receptor-positive, HER2-negative (HRpos/HER2neg) early breast cancer (eBC) remains debated, particularly the choice between aromatase inhibitors plus ovarian function suppression (AI + OFS) or tamoxifen (TAM) with or without additional OFS. This study assessed the use of adjuvant endocrine therapies for premenopausal patients with intermediate/high-risk HRpos/HER2neg eBC.

Methods

CLEAR-B (AGO-B-059; NCT05870813) was a retrospective study analyzing data, collected from January 2016 to June 2019 and from January 2022 to December 2023 during the certification process of breast centers in Germany. Premenopausal patients with HRpos/HER2neg intermediate/high-risk eBC were eligible. Patient and disease characteristics, in addition to recommended and received adjuvant treatments, were evaluated.

Results

The number of registered patients was 3137, of whom 2789 had complete information on endocrine treatments (1717 for 2016–2019 and 1072 for 2022–2023). In 2016–2019, 8.4 % of the patients were recommended to be treated with AI + OFS, whereas in 2022–2023, the proportion of patients with a treatment recommendation for AI + OFS rose to 42.1 %. In 2016–2019, TAM monotherapy was most frequently recommended (80.8 %). Conversely, TAM + OFS was not commonly recommended (9.3 % in 2016–2019 and 16.5 % in 2022–2023). While no clear association between tumor stage and chosen endocrine therapy was found in 2016–2019, most patients with ≥stage IIA were recommended to be treated with AI + OFS in 2022–2023.

Conclusion

This analysis shows that treatment recommendation for AI + OFS in premenopausal patients with HRpos/HER2neg eBC increased relevantly in the past years, reflecting latest guideline recommendations.

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芳香酶抑制剂、他莫昔芬和卵巢功能抑制在早期激素受体阳性、her2阴性乳腺癌复发风险增加的绝经前患者中的实际应用

绝经前激素受体阳性，her2阴性（HRpos/ her2阴性）早期乳腺癌（eBC）患者的最佳辅助内分泌治疗仍存在争议，特别是芳香化酶抑制剂加卵巢功能抑制（AI + OFS）或他莫昔芬（TAM）加或不加OFS的选择。本研究评估了绝经前中/高危HRpos/ her2阴性bc患者辅助内分泌治疗的使用情况。MethodsCLEAR-B(前- b - 059;NCT05870813)是一项回顾性研究，分析了2016年1月至2019年6月和2022年1月至2023年12月在德国乳房中心认证过程中收集的数据。绝经前HRpos/ her2阴性中/高危eBC患者入选。除了推荐和接受的辅助治疗外，还评估了患者和疾病的特征。结果登记患者3137例，其中有完整内分泌治疗信息的患者2789例（2016-2019年1717例，2022-2023年1072例）。2016-2019年，8.4%的患者被推荐使用AI + OFS治疗，而2022-2023年，推荐使用AI + OFS治疗的患者比例上升至42.1%。2016-2019年，最常推荐的是TAM单药治疗（80.8%）。相反，TAM + OFS不常被推荐（2016-2019年为9.3%，2022-2023年为16.5%）。虽然2016-2019年肿瘤分期与所选择的内分泌治疗没有明确的相关性，但大多数≥IIA期的患者在2022-2023年被推荐使用AI + OFS治疗。结论本分析显示，HRpos/ her2阴性bc绝经前患者AI + OFS的治疗建议在过去几年中有所增加，反映了最新的指南建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast 医学-妇产科学

CiteScore

8.70

自引率

2.60%

发文量

165

审稿时长

59 days

期刊介绍： The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.