Lammers S W M, Geurts S M E, Hermans K E P E, Kooreman L F S, Swinkels A C P, Smorenburg C H, van der Sangen M J C, Kroep J R, Honkoop A H, van den Berkmortel F W P J, de Roos W K, Linn S C, Imholz A L T, Vriens I J H, Tjan-Heijnen V C G
Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht, The Netherlands.
Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht, The Netherlands.
ESMO Open. 2025 Feb;10(2):104154. doi: 10.1016/j.esmoop.2025.104154. Epub 2025 Feb 7.
This study determines the prognostic value of the luminal-like subtype in patients with hormone receptor-positive breast cancer and explores whether the efficacy of extended anastrozole therapy differs between patients with luminal A-like versus luminal B-like tumours.
The phase III DATA study (NCT00301457) examined the efficacy of 6 versus 3 years of anastrozole in postmenopausal women with early-stage hormone receptor-positive breast cancer who had received 2-3 years of tamoxifen. Patients with available formalin-fixed paraffin-embedded tissue blocks were identified and classified by immunohistochemical luminal-like subtype. Distant recurrence (DR) and breast cancer-specific mortality (BCSM) were compared by luminal-like subtype and treatment arm using competing risk methods.
This study included 788 patients: 491 had a luminal A-like tumour and 297 had a luminal B-like tumour. The median follow-up time was 13.1 years. Patients with luminal B-like tumours experienced a higher risk of DR [subdistribution hazard ratio (sHR) 1.44, 95% confidence interval (CI) 1.03-2.01, P = 0.03] and BCSM (sHR 1.68, 95% CI 1.15-2.45, P = 0.008) than patients with luminal A-like tumours. The efficacy of extended anastrozole therapy differed between patients with luminal A-like tumours (DR: sHR 0.51, 95% CI 0.30-0.88, P = 0.02; BCSM: sHR 0.39, 95% CI 0.19-0.82, P = 0.01) and patients with luminal B-like tumours (DR: sHR 2.09, 95% CI 0.96-4.53, P = 0.06; BCSM: sHR 2.36, 95% CI 0.80-7.00, P = 0.12) (P-interaction = 0.03 and P-interaction = 0.06, respectively).
In patients with hormone receptor-positive breast cancer, the luminal B-like subtype was associated with a significantly worse prognosis when compared with the luminal A-like subtype. Extended anastrozole therapy halved the risk of DR and BCSM in patients with luminal A-like tumours, whereas no effect was seen in patients with luminal B-like tumours.
本研究确定管腔样亚型在激素受体阳性乳腺癌患者中的预后价值，并探讨延长阿那曲唑治疗对管腔 A 样与管腔 B 样肿瘤患者疗效是否存在差异。
III 期 DATA 研究（NCT00301457）考察了阿那曲唑 6 年与 3 年治疗对接受 2 - 3 年他莫昔芬治疗的绝经后早期激素受体阳性乳腺癌女性的疗效。对有可用福尔马林固定石蜡包埋组织块的患者进行识别，并通过免疫组化管腔样亚型进行分类。采用竞争风险方法，按管腔样亚型和治疗组比较远处复发（DR）和乳腺癌特异性死亡率（BCSM）。
本研究纳入 788 例患者：491 例为管腔 A 样肿瘤，297 例为管腔 B 样肿瘤。中位随访时间为 13.1 年。管腔 B 样肿瘤患者的 DR 风险更高[亚分布风险比（sHR）1.44，95%置信区间（CI）1.03 - 2.01，P = 0.03]，BCSM 风险也更高（sHR 1.68，95%CI 1.15 - 2.45，P = 0.008），高于管腔 A 样肿瘤患者。延长阿那曲唑治疗对管腔 A 样肿瘤患者（DR：sHR 0.51，95%CI 0.30 - 0.88，P = 0.02；BCSM：sHR 0.39，95%CI 0.19 - 0.82，P = 0.01）和管腔 B 样肿瘤患者（DR：sHR 2.09，95%CI 0.96 - 4.53，P = 0.06；BCSM：sHR 2.36，95%CI 0.80 - 7.00，P = 0.12）的疗效不同（P 交互作用分别为 0.03 和 0.06）。
在激素受体阳性乳腺癌患者中，与管腔 A 样亚型相比，管腔 B 样亚型的预后明显更差。延长阿那曲唑治疗使管腔 A 样肿瘤患者的 DR 和 BCSM 风险减半，而对管腔 B 样肿瘤患者无此效果。
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