单激素受体阳性与双激素受体阳性乳腺癌的结局。GEICAM/9906 子研究。

Outcomes of single versus double hormone receptor-positive breast cancer. A GEICAM/9906 sub-study.

机构信息

Department of Medical Oncology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada.

Complejo Hospitalario de Albacete, Albacete, Spain; GEICAM (Spanish Breast Cancer Group), Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain.

出版信息

Eur J Cancer. 2018 May;94:199-205. doi: 10.1016/j.ejca.2018.02.018. Epub 2018 Mar 21.

DOI:10.1016/j.ejca.2018.02.018

PMID:29573665

Abstract

BACKGROUND

Retrospective data suggest better outcomes for patients with double hormonal receptor (oestrogen [ER] and progesterone receptor [PgR])-positive (dHR+) early breast cancer, compared with single hormonal receptor-positive, sHR+, (ER+/PgR- or ER-/PgR+) disease. Here, we evaluate the classification according to intrinsic subtypes and clinical outcomes of sHR+ versus dHR+ in HER2-negative breast cancer patients enrolled in GEICAM/9906 study (NCT00129922).

METHODS

Archival tumours were retrieved retrospectively for the analysis of ER, PgR and HER2 status and classified into intrinsic subtypes using the PAM50 gene expression assay. Disease-free survival (DFS) and overall survival (OS) were explored using a Cox proportional hazard analysis.

RESULTS

Data on intrinsic subtypes were available in 571 (50%) patients with ER+ and/or PR+, and HER2-negative primary tumours. The incidence of luminal A and luminal B subtypes were 52%/36% in dHR+ tumours (ER+/PgR+), and 15%/58% in ER+/PgR-tumours. ER-/PgR+ tumours were mainly luminal A (52%). Compared with ER+/PgR+ patients, DFS was similar in ER-/PgR+ (hazard ratio [HR] 1.15, 95% confidence interval [CI] 0.57-2.34, p = 0.70) but worse in ER+/PgR- patients (HR 1.60, 95% CI 1.12-2.28, p < 0.01). Similar results were observed for OS (HR 1.50, p = 0.30 and HR 1.86, p < 0.01, respectively).

CONCLUSIONS

The ER+/PgR- group is characterised by higher proliferation and worse outcomes. In spite of the ER-/PgR+ subgroup resembles ER+/PgR+ disease in terms of molecular subtypes and outcomes, the small number of patients in this subgroup prevents from drawing any conclusions.

TRIAL REGISTRATION

EudraCT: 2005-003108-12 (retrospectively registered 28/06/2005). CLINICALTRIALS.

GOV IDENTIFIER

NCT00129922 (retrospectively registered 10/08/2005).

摘要

背景

回顾性数据表明，与单激素受体阳性（sHR+，ER+/PgR- 或 ER-/PgR+）疾病相比，双激素受体（雌激素 [ER] 和孕激素受体 [PgR]）阳性（dHR+）早期乳腺癌患者的预后更好。在这里，我们评估了 GEICAM/9906 研究（NCT00129922）中入组的 HER2 阴性乳腺癌患者中根据内在亚型和 sHR+与 dHR+的临床结果进行的分类。

方法

回顾性检索存档肿瘤，分析 ER、PgR 和 HER2 状态，并使用 PAM50 基因表达分析将其分类为内在亚型。使用 Cox 比例风险分析探讨无病生存（DFS）和总生存（OS）。

结果

在 571 名（50%）ER+和/或 PR+、HER2 阴性原发性肿瘤患者中，可获得内在亚型数据。在 dHR+肿瘤（ER+/PgR+）中，luminal A 和 luminal B 亚型的发生率分别为 52%/36%，而 ER+/PgR-肿瘤中分别为 15%/58%。ER-/PgR+肿瘤主要为 luminal A（52%）。与 ER+/PgR+患者相比，ER-/PgR+（HR 1.15，95%CI 0.57-2.34，p=0.70）和 ER+/PgR-（HR 1.60，95%CI 1.12-2.28，p<0.01）患者的 DFS 相似。OS 也观察到类似的结果（HR 1.50，p=0.30 和 HR 1.86，p<0.01，分别）。