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OFS plus AI or SERM vs. SERM alone in premenopausal women with hormone receptor-positive breast cancer: a prospective cohort study using the real-world database

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Abstract

Background

Ovarian function suppression (OFS) plus other endocrine treatment was recommended to hormone receptor (HR)-positive breast cancer by some guidelines recently. We performed this study to validate the survival benefits of OFS plus aromatase inhibitors (AI) or selective estrogen receptor modulators (SERM) in the real world.

Methods

All premenopausal, HR-positive breast cancer patients diagnosed between 1996 and 2017 were identified. Eligible patients were classified into three groups according to their adjuvant endocrine treatment, including OFS plus AI, OFS plus SERM and SERM alone. The primary outcome is invasive disease-free survival (iDFS), whereas the secondary outcome is overall survival (OS). Cox proportional hazards models and propensity score adjusted models were used to compare the survival benefits in three groups.

Results

We included 2838 patients, of which 246 received OFS plus AI, 175 received OFS plus SERM, and 2417 received SERM alone. Compared with SERM alone, OFS plus AI was associated with an improved iDFS (HR 0.59, 95% CI 0.36–0.96) and OS (HR 0.26, 95% CI 0.08–0.85). OFS plus SERM, however, was not significantly associated with extended iDFS or OS. Among patients older than 40 years old, OFS plus AI was more effective than OFS plus SERM (HR 0.38, 95% CI 0.17–0.88) or SERM alone (HR 0.44, 95% CI 0.23–0.84) in terms of iDFS.

Conclusions

Our findings suggest that OFS plus AI treatment may extend both iDFS and OS among premenopausal patients with hormone receptor-positive breast cancer in the real world.

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Funding

This work was supported by grants from the National Natural Science Foundation of China (81202099).

Author information

Authors and Affiliations

  1. Laboratory of Molecular Diagnosis of Cancer, Clinical Research Center for Breast, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, People’s Republic of China

    Kejia Hu, Qian Peng, Xiaorong Zhong, Ling Deng, Yuxin Xie, Donghao Lu & Hong Zheng

  2. Department of Head, Neck and Mammary Gland Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, People’s Republic of China

    Ping He, Xiaorong Zhong, Yuxin Xie, Donghao Lu & Hong Zheng

  3. Department of Epidemiology, West China School of Public Health, Sichuan University, No. 16 Ren Min Nan Lu, Chengdu, Sichuan, People’s Republic of China

    Jiayuan Li & Hongping Xu

  4. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77, Stockholm, Sweden

    Kejia Hu & Donghao Lu

Authors
  1. Kejia Hu
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  2. Ping He
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  3. Qian Peng
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  4. Xiaorong Zhong
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  5. Ling Deng
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  6. Yuxin Xie
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  7. Jiayuan Li
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  8. Hongping Xu
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  9. Donghao Lu
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  10. Hong Zheng
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Corresponding author

Correspondence to Hong Zheng.

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Ethical standards

This study was approved by Biomedical Research Ethics Committee (approval number: 2012130), West China Hospital, Sichuan University and performed in accordance with the ethical standards laid down in the 1964 declaration of Helsinki and all subsequent revisions.

Informed consent

The informed consents were obtained from all participants. Permissions were, therefore, obtained to collect and store their related information, and used for medical research. All patients’ anonymity and privacy are carefully protected.

Conflict of interest

The authors declare that they have no potential conflict of interest.

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Hu, K., He, P., Peng, Q. et al. OFS plus AI or SERM vs. SERM alone in premenopausal women with hormone receptor-positive breast cancer: a prospective cohort study using the real-world database. Breast Cancer 26, 339–348 (2019). https://doi.org/10.1007/s12282-018-0929-6

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  • DOI: https://doi.org/10.1007/s12282-018-0929-6

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