Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, P.O. Box 5800, 6202 AZ, Maastricht, the Netherlands.
Department of Medical Oncology, Catharina Hospital, Eindhoven, the Netherlands.
Breast Cancer Res Treat. 2024 Nov;208(1):179-192. doi: 10.1007/s10549-024-07411-w. Epub 2024 Jun 28.
Patients with chemotherapy-induced ovarian function failure (CIOFF) may experience ovarian function recovery (OFR). Earlier, we showed that OFR during treatment with anastrozole impacted the prognosis of hormone receptor-positive (HR+) breast cancer (BC) patients with CIOFF. Here, we present the long-term follow-up results.
Postmenopausal women with HR+ BC who were 45-57 years of age and received chemotherapy were identified from the phase 3 DATA study (NCT00301457) on the extended use of anastrozole. Eligible patients were categorised into two groups: patients with CIOFF and definitely postmenopausal patients. Patients with CIOFF were monitored for OFR. Disease-free survival (DFS), distant recurrence-free survival (DRFS), and overall survival (OS) were compared between patients with OFR and patients without OFR using multivariable Cox regression analyses, including OFR as a time-dependent covariate. BC-specific mortality (BCSM) was compared between groups using the Fine and Gray method.
This study included 656 patients: 395 patients with CIOFF and 261 definitely postmenopausal patients. OFR occurred in 39 (12%) of 329 patients with CIOFF who were monitored for OFR. The median follow-up time was 13.3 years. Patients with OFR experienced a deterioration in DFS (hazard ratio (HR) = 1.54; 95% confidence interval (CI) 0.85-2.81), DRFS (HR = 1.51; 95% CI 0.73-3.11), OS (HR = 1.64; 95% CI 0.75-3.55), and BCSM (subdistribution HR = 1.98; 95% CI 0.84-4.63) when compared with patients without OFR.
In patients with CIOFF, OFR during treatment with anastrozole was associated with a deterioration in BC outcomes. These findings underscore the importance of adequate ovarian function suppression in this subgroup of patients.
化疗诱导的卵巢功能衰竭（CIOFF）患者可能会经历卵巢功能恢复（OFR）。此前，我们发现，接受阿那曲唑治疗期间的 OFR 会影响 CIOFF 激素受体阳性（HR+）乳腺癌（BC）患者的预后。本研究报告了其长期随访结果。
从阿那曲唑扩展使用的 3 期 DATA 研究（NCT00301457）中确定了 45-57 岁接受化疗的 HR+BC 绝经后女性。将符合条件的患者分为两组：CIOFF 患者和确定绝经后患者。监测 CIOFF 患者的 OFR。采用多变量 Cox 回归分析比较 OFR 患者和无 OFR 患者的无病生存（DFS）、远处无复发生存（DRFS）和总生存（OS），OFR 作为时依协变量。采用 Fine 和 Gray 方法比较两组的 BC 特异性死亡率（BCSM）。
本研究纳入了 656 例患者：395 例 CIOFF 患者和 261 例确定绝经后患者。在监测 OFR 的 329 例 CIOFF 患者中，有 39 例（12%）发生 OFR。中位随访时间为 13.3 年。与无 OFR 患者相比，有 OFR 患者的 DFS（风险比（HR）=1.54；95%置信区间（CI）0.85-2.81）、DRFS（HR=1.51；95% CI 0.73-3.11）、OS（HR=1.64；95% CI 0.75-3.55）和 BCSM（亚分布 HR=1.98；95% CI 0.84-4.63）恶化。
在 CIOFF 患者中，阿那曲唑治疗期间的 OFR 与 BC 结局恶化相关。这些发现强调了在这一亚组患者中充分抑制卵巢功能的重要性。
