激素受体阳性早期乳腺癌绝经前患者辅助内分泌治疗选择：来自前瞻性 GIM23-POSTER 研究的见解。

Adjuvant endocrine therapy choices in premenopausal patients with hormone receptor-positive early breast cancer: Insights from the prospective GIM23-POSTER study.

机构信息

Department of Medical Oncology, Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Bruxelles, Belgium.

Department of Medical Oncology, Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.

出版信息

Breast. 2024 Oct;77:103769. doi: 10.1016/j.breast.2024.103769. Epub 2024 Jul 9.

DOI:10.1016/j.breast.2024.103769

PMID:39043079

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11325348/

Abstract

BACKGROUND

Most premenopausal patients with early breast cancer (eBC) are diagnosed with hormone receptor-positive disease and therefore candidate for adjuvant endocrine therapy (ET).

PATIENTS AND METHODS

The Gruppo Italiano Mammella (GIM) 23-POSTER (GIM23) is a multicenter, prospective, observational study conducted in 26 Italian institutions, aiming to evaluate ET choices for premenopausal patients affected by hormone receptor-positive eBC in a real-world setting. Here we report also the results in terms of type of ET prescribed according to the definition of high-risk patients by monarchE and NATALEE trials.

RESULTS

Between October 2019 and June 2022, 600 premenopausal patients were included, with a median age of 46 years. Almost half (271, 45.2 %) of the patients had stage I disease, while 254 (42.3 %) and 60 (10.0 %) patients had stage II and III, respectively. Overall, 149 (25.1 %) patients received tamoxifen alone, 83 (14.0 %) tamoxifen with ovarian function suppression (OFS), while 361 (60.9 %) received aromatase inhibitor (AI) with OFS. Patients treated with AI and OFS had higher number of metastatic axillary nodes, higher grade and more often received chemotherapy (all p < 0.001). According to the inclusion criteria of the monarchE and NATALEE trials, 81 patients (15.6 %) were considered high-risk for the monarchE and received AI with OFS in 88.9 % of the cases, while 231 patients (44.4 %) were considered high-risk for the NATALEE trial and received AI with OFS in 74.5 % of cases.

CONCLUSIONS

AI with OFS is the most prescribed adjuvant ET among premenopausal patients, especially in the presence of high-risk features.

摘要

背景

大多数绝经前早期乳腺癌（eBC）患者被诊断为激素受体阳性疾病，因此是辅助内分泌治疗（ET）的候选者。

患者和方法

意大利乳腺小组（GIM）23-POSTER（GIM23）是一项在 26 家意大利机构进行的多中心、前瞻性、观察性研究，旨在评估绝经前激素受体阳性 eBC 患者在真实环境中接受 ET 的选择。在这里，我们还根据 monarchE 和 NATALEE 试验中高危患者的定义报告了根据 ET 类型规定的结果。

结果

2019 年 10 月至 2022 年 6 月期间，共纳入 600 例绝经前患者，中位年龄为 46 岁。近一半（271 例，45.2%）患者为 I 期疾病，254 例（42.3%）和 60 例（10.0%）患者分别为 II 期和 III 期。总体而言，149 例（25.1%）患者接受单独他莫昔芬治疗，83 例（14.0%）患者接受他莫昔芬联合卵巢功能抑制（OFS）治疗，而 361 例（60.9%）患者接受芳香化酶抑制剂（AI）联合 OFS 治疗。接受 AI 和 OFS 治疗的患者腋窝淋巴结转移数量更多、肿瘤分级更高且更常接受化疗（均 p<0.001）。根据 monarchE 和 NATALEE 试验的纳入标准，81 例（15.6%）患者被认为是 monarchE 的高危患者，其中 88.9%的患者接受 AI 联合 OFS 治疗，而 231 例（44.4%）患者被认为是 NATALEE 试验的高危患者，其中 74.5%的患者接受 AI 联合 OFS 治疗。