Milena Beierlein, Lothar Häberle, Naiba Nabieva, Nicolai Maass, Bahriye Aktas, Sherko Kümmel, Christoph Thomssen, Christopher Wolf, Hans-Christian Kolberg, Cosima Brucker, Wolfgang Janni, Peter Dall, Andreas Schneeweiss, Frederik Marme, Marc W Sütterlin, Matthias Ruebner, Anna-Katharin Theuser, Nadine M Hofmann, Sybille Böhm, Katrin Almstedt, Sara Kellner, Paul Gass, Hans-Joachim Lück, Alexander Hein, Sabine Schmatloch, Matthias Kalder, Christoph Uleer, Ingolf Juhasz-Böss, Volker Hanf, Christian Jackisch, Volkmar Müller, Brigitte Rack, Erik Belleville, Diethelm Wallwiener, Achim Rody, Claudia Rauh, Chistian M Bayer, Sabrina Uhrig, Hanna Huebner, Chloë Goossens, Sara Y Brucker, Carolin C Hack, Tanja N Fehm, Peter A Fasching
{"title":"绝经后激素受体阳性、her2阴性早期乳腺癌患者接受来曲唑治疗后（新）辅助化疗后的侵袭性无病和总生存率：来自IV期前言试验的经验","authors":"Milena Beierlein, Lothar Häberle, Naiba Nabieva, Nicolai Maass, Bahriye Aktas, Sherko Kümmel, Christoph Thomssen, Christopher Wolf, Hans-Christian Kolberg, Cosima Brucker, Wolfgang Janni, Peter Dall, Andreas Schneeweiss, Frederik Marme, Marc W Sütterlin, Matthias Ruebner, Anna-Katharin Theuser, Nadine M Hofmann, Sybille Böhm, Katrin Almstedt, Sara Kellner, Paul Gass, Hans-Joachim Lück, Alexander Hein, Sabine Schmatloch, Matthias Kalder, Christoph Uleer, Ingolf Juhasz-Böss, Volker Hanf, Christian Jackisch, Volkmar Müller, Brigitte Rack, Erik Belleville, Diethelm Wallwiener, Achim Rody, Claudia Rauh, Chistian M Bayer, Sabrina Uhrig, Hanna Huebner, Chloë Goossens, Sara Y Brucker, Carolin C Hack, Tanja N Fehm, Peter A Fasching","doi":"10.1002/ijc.70037","DOIUrl":null,"url":null,"abstract":"<p><p>Patients with hormone receptor-positive (HRpos), HER2-negative (HER2neg) breast cancer (BC) benefit less from neoadjuvant chemotherapy (NACT) than patients with triple-negative and HER2-positive BC. In this retrospective analysis of the phase IV PreFace clinical trial (NCT01908556), where postmenopausal HRpos BC patients (n = 3297) were treated with 5-year upfront adjuvant letrozole therapy, we evaluated the prognosis of patients treated with adjuvant versus neoadjuvant chemotherapy in HRpos/HER2neg early-stage BC. HRpos/HER2neg patients with information on (neo)adjuvant chemotherapy (n = 2895) were retrospectively selected from all patients enrolled in the PreFace trial. Invasive disease-free survival (iDFS) and overall survival (OS) were compared between patient groups that were treated with neoadjuvant or adjuvant chemotherapy. Chemotherapy was given to 1051 patients (36.3% of all patients), of which 874 (83.2%) received adjuvant chemotherapy and 177 (16.8%) NACT. Pathologic complete response (pCR) rate in the NACT group was 6.9%. Patients treated with NACT had a worse outcome than those treated with adjuvant chemotherapy (5-year iDFS rate 81% vs. 88%; 5-year OS rate 89% vs. 93%). This effect was maintained after adjusting for age, BMI, lymph node status, grading, tumor size, and histology (hazard ratio for iDFS: 1.95 (95%CI: 1.28-2.95); hazard ratio for OS: 2.13 (95%CI: 1.24-3.66)). Further adjustment for taxane-based regimes did not alter results. In conclusion, in this retrospective analysis of patients with early-stage HRpos/HER2neg BC, patients with NACT had a more unfavorable prognosis than patients treated adjuvantly, independent of patient and tumor characteristics. Prognosis of neoadjuvant patients might be affected by resistance mechanisms, warranting further investigation.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Invasive disease-free and overall survival after (neo)adjuvant chemotherapy in postmenopausal patients with hormone receptor-positive, HER2-negative early breast cancer treated with upfront letrozole: Experiences from the phase IV PreFace trial.\",\"authors\":\"Milena Beierlein, Lothar Häberle, Naiba Nabieva, Nicolai Maass, Bahriye Aktas, Sherko Kümmel, Christoph Thomssen, Christopher Wolf, Hans-Christian Kolberg, Cosima Brucker, Wolfgang Janni, Peter Dall, Andreas Schneeweiss, Frederik Marme, Marc W Sütterlin, Matthias Ruebner, Anna-Katharin Theuser, Nadine M Hofmann, Sybille Böhm, Katrin Almstedt, Sara Kellner, Paul Gass, Hans-Joachim Lück, Alexander Hein, Sabine Schmatloch, Matthias Kalder, Christoph Uleer, Ingolf Juhasz-Böss, Volker Hanf, Christian Jackisch, Volkmar Müller, Brigitte Rack, Erik Belleville, Diethelm Wallwiener, Achim Rody, Claudia Rauh, Chistian M Bayer, Sabrina Uhrig, Hanna Huebner, Chloë Goossens, Sara Y Brucker, Carolin C Hack, Tanja N Fehm, Peter A Fasching\",\"doi\":\"10.1002/ijc.70037\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Patients with hormone receptor-positive (HRpos), HER2-negative (HER2neg) breast cancer (BC) benefit less from neoadjuvant chemotherapy (NACT) than patients with triple-negative and HER2-positive BC. In this retrospective analysis of the phase IV PreFace clinical trial (NCT01908556), where postmenopausal HRpos BC patients (n = 3297) were treated with 5-year upfront adjuvant letrozole therapy, we evaluated the prognosis of patients treated with adjuvant versus neoadjuvant chemotherapy in HRpos/HER2neg early-stage BC. HRpos/HER2neg patients with information on (neo)adjuvant chemotherapy (n = 2895) were retrospectively selected from all patients enrolled in the PreFace trial. Invasive disease-free survival (iDFS) and overall survival (OS) were compared between patient groups that were treated with neoadjuvant or adjuvant chemotherapy. Chemotherapy was given to 1051 patients (36.3% of all patients), of which 874 (83.2%) received adjuvant chemotherapy and 177 (16.8%) NACT. Pathologic complete response (pCR) rate in the NACT group was 6.9%. Patients treated with NACT had a worse outcome than those treated with adjuvant chemotherapy (5-year iDFS rate 81% vs. 88%; 5-year OS rate 89% vs. 93%). This effect was maintained after adjusting for age, BMI, lymph node status, grading, tumor size, and histology (hazard ratio for iDFS: 1.95 (95%CI: 1.28-2.95); hazard ratio for OS: 2.13 (95%CI: 1.24-3.66)). Further adjustment for taxane-based regimes did not alter results. In conclusion, in this retrospective analysis of patients with early-stage HRpos/HER2neg BC, patients with NACT had a more unfavorable prognosis than patients treated adjuvantly, independent of patient and tumor characteristics. 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引用次数: 0
摘要
激素受体阳性（HRpos）、her2阴性（HER2neg）乳腺癌（BC）患者从新辅助化疗（NACT）中获益少于三阴性和her2阳性乳腺癌患者。在这项IV期临床试验（NCT01908556）的回顾性分析中，绝经后HRpos BC患者（n = 3297）接受了5年的前期辅助来曲唑治疗，我们评估了HRpos/ her2阴性早期BC患者接受辅助化疗与新辅助化疗的预后。具有（neo）辅助化疗信息的HRpos/ her2阴性患者（n = 2895）从所有参加前言试验的患者中回顾性选择。比较新辅助化疗组和辅助化疗组患者的侵袭性无病生存期（iDFS）和总生存期（OS）。化疗1051例（占全部患者的36.3%），其中辅助化疗874例（83.2%），NACT 177例（16.8%）。NACT组病理完全缓解（pCR）率为6.9%。接受NACT治疗的患者预后比辅助化疗的患者差(5年iDFS为81% vs. 88%；5年生存率89% vs. 93%)。在调整了年龄、BMI、淋巴结状况、分级、肿瘤大小和组织学后，这种效果仍然存在(iDFS的风险比：1.95 (95%CI: 1.28-2.95)；OS风险比：2.13 （95%CI: 1.24-3.66）。进一步调整紫杉烷为基础的制度没有改变结果。总之，在这项对早期HRpos/ her2阴性BC患者的回顾性分析中，与患者和肿瘤特征无关，NACT患者的预后比辅助治疗的患者更不利。新辅助治疗患者的预后可能受耐药机制的影响，值得进一步研究。
Invasive disease-free and overall survival after (neo)adjuvant chemotherapy in postmenopausal patients with hormone receptor-positive, HER2-negative early breast cancer treated with upfront letrozole: Experiences from the phase IV PreFace trial.
Patients with hormone receptor-positive (HRpos), HER2-negative (HER2neg) breast cancer (BC) benefit less from neoadjuvant chemotherapy (NACT) than patients with triple-negative and HER2-positive BC. In this retrospective analysis of the phase IV PreFace clinical trial (NCT01908556), where postmenopausal HRpos BC patients (n = 3297) were treated with 5-year upfront adjuvant letrozole therapy, we evaluated the prognosis of patients treated with adjuvant versus neoadjuvant chemotherapy in HRpos/HER2neg early-stage BC. HRpos/HER2neg patients with information on (neo)adjuvant chemotherapy (n = 2895) were retrospectively selected from all patients enrolled in the PreFace trial. Invasive disease-free survival (iDFS) and overall survival (OS) were compared between patient groups that were treated with neoadjuvant or adjuvant chemotherapy. Chemotherapy was given to 1051 patients (36.3% of all patients), of which 874 (83.2%) received adjuvant chemotherapy and 177 (16.8%) NACT. Pathologic complete response (pCR) rate in the NACT group was 6.9%. Patients treated with NACT had a worse outcome than those treated with adjuvant chemotherapy (5-year iDFS rate 81% vs. 88%; 5-year OS rate 89% vs. 93%). This effect was maintained after adjusting for age, BMI, lymph node status, grading, tumor size, and histology (hazard ratio for iDFS: 1.95 (95%CI: 1.28-2.95); hazard ratio for OS: 2.13 (95%CI: 1.24-3.66)). Further adjustment for taxane-based regimes did not alter results. In conclusion, in this retrospective analysis of patients with early-stage HRpos/HER2neg BC, patients with NACT had a more unfavorable prognosis than patients treated adjuvantly, independent of patient and tumor characteristics. Prognosis of neoadjuvant patients might be affected by resistance mechanisms, warranting further investigation.
期刊介绍：
The International Journal of Cancer (IJC) is the official journal of the Union for International Cancer Control—UICC; it appears twice a month. IJC invites submission of manuscripts under a broad scope of topics relevant to experimental and clinical cancer research and publishes original Research Articles and Short Reports under the following categories:
-Cancer Epidemiology-
Cancer Genetics and Epigenetics-
Infectious Causes of Cancer-
Innovative Tools and Methods-
Molecular Cancer Biology-
Tumor Immunology and Microenvironment-
Tumor Markers and Signatures-
Cancer Therapy and Prevention
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