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Erschienen in:

04.02.2021 | Clinical trial

Real-world data on neoadjuvant endocrine therapy in ER-positive/HER2-negative breast cancer

verfasst von: Leonardo Roberto da Silva, Camila Annicchino de Andrade, Fabrício Brenelli, Susana Ramalho, Tomás Reinert, Alessandra Borba Anton de Souza, Ana Elisa Ribeiro da Silva, Maria Beatriz de Paula Leite Kraft, Vivian Castro Antunes de Vasconcelos, Antônio Luiz Frasson, Renato Zochio Torresan, Cesar Cabello, Matthew J. Ellis, Luiz Carlos Zeferino

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2021

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Abstract

Purpose

Neoadjuvant endocrine therapy (NET) has been shown to be effective in ER-positive/HER2-negative breast cancer in clinical trials. However, adoption in clinical practice is still limited. Real-world data may provide useful insights into effectiveness, toxicities and quality of care, potentially rendering clinical trial results to the real-world setting. Our purpose was to report real-world data of a cohort of postmenopausal patients submitted to NET.

Methods

This prospective cohort study evaluated 146 postmenopausal female patients with ER-positive/HER2-negative breast cancer treated with NET at three tertiary hospitals between 2016 and 2018. Clinicopathological information were collected prospectively. Preoperative Endocrine Prognostic Index (PEPI) score was calculated for tumors submitted to at least 16 weeks of NET.

Results

Median age was 67 years old, and 87.8% had stage I-II disease. Most tumors had histological grade II (76.1%). Median pretreatment Ki67 expression was 10%. Aromatase inhibitor was used in 99.5% of patients, and median treatment duration was 21.0 weeks. No tumor progressed during NET. Breast-conserving surgery was performed in the majority of patients (63.0%), as well as sentinel lymph-node biopsy (76.7%). Pathological complete response rate was 1.0%. 43 patients (29.5%) had PEPI score 0, and 26% had PEPI scores 4–5. Posttreatment Ki67 median expression was 3.0%, and only five tumors (3.4%) showed marked increase in Ki67 expression during treatment. Seven patients (4.8%) had HER2-positive residual disease, and were treated with adjuvant chemotherapy plus trastuzumab.

Conclusions

Our real-world data shows that NET is effective and safe in postmenopausal patients with ER-positive/HER2-negative breast cancer. Postmenopausal status and low-risk luminal tumor features (luminal A-like) should be used as selection criteria to ensure the best results with NET.

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Titel: Real-world data on neoadjuvant endocrine therapy in ER-positive/HER2-negative breast cancer
verfasst von: Leonardo Roberto da Silva
Camila Annicchino de Andrade
Fabrício Brenelli
Susana Ramalho
Tomás Reinert
Alessandra Borba Anton de Souza
Ana Elisa Ribeiro da Silva
Maria Beatriz de Paula Leite Kraft
Vivian Castro Antunes de Vasconcelos
Antônio Luiz Frasson
Renato Zochio Torresan
Cesar Cabello
Matthew J. Ellis
Luiz Carlos Zeferino
Publikationsdatum: 04.02.2021
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 3/2021
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-020-06076-5

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Real-world data on neoadjuvant endocrine therapy in ER-positive/HER2-negative breast cancer