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Breast Cancer Research and Treatment

, Volume 116, Issue 3, pp 491–500 | Cite as

Is adjuvant chemotherapy of benefit for postmenopausal women who receive endocrine treatment for highly endocrine-responsive, node-positive breast cancer? International Breast Cancer Study Group Trials VII and 12–93

  • Olivia PaganiEmail author
  • Shari Gelber
  • Edda Simoncini
  • Monica Castiglione-Gertsch
  • Karen N. PriceEmail author
  • Richard D. Gelber
  • Stig B. Holmberg
  • Diana Crivellari
  • John Collins
  • Jurij Lindtner
  • Beat Thürlimann
  • Martin F. Fey
  • Elizabeth Murray
  • John F. Forbes
  • Alan S. Coates
  • Aron Goldhirsch
  • for the International Breast Cancer Study Group
Clinical Trial

Abstract

To compare the efficacy of chemoendocrine treatment with that of endocrine treatment (ET) alone for postmenopausal women with highly endocrine responsive breast cancer. In the International Breast Cancer Study Group (IBCSG) Trials VII and 12–93, postmenopausal women with node-positive, estrogen receptor (ER)-positive or ER-negative, operable breast cancer were randomized to receive either chemotherapy or endocrine therapy or combined chemoendocrine treatment. Results were analyzed overall in the cohort of 893 patients with endocrine-responsive disease, and according to prospectively defined categories of ER, age and nodal status. STEPP analyses assessed chemotherapy effect. The median follow-up was 13 years. Adding chemotherapy reduced the relative risk of a disease-free survival event by 19% (P = 0.02) compared with ET alone. STEPP analyses showed little effect of chemotherapy for tumors with high levels of ER expression (P = 0.07), or for the cohort with one positive node (P = 0.03). Chemotherapy significantly improves disease-free survival for postmenopausal women with endocrine-responsive breast cancer, but the magnitude of the effect is substantially attenuated if ER levels are high.

Keywords

Breast cancer Chemoendocrine therapy Estrogen receptors Postmenopausal 

Notes

Acknowledgments

We thank the patients, physicians, nurses, and data managers who have participated in the International Breast Cancer Study Group (see Appendix) trials, now and for the past 30 years. The IBCSG is funded in part by: Swiss Group for Clinical Cancer Research (SAKK), Frontier Science and Technology Research Foundation (FSTRF), The Cancer Council Australia, Australian New Zealand Breast Cancer Trials Group (National Health Medical Research Council), National Cancer Institute (CA-75362), Swedish Cancer Society, Cancer Research Switzerland/Oncosuisse, Cancer Association of South Africa, Foundation for Clinical Cancer Research of Eastern Switzerland (OSKK).

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Copyright information

© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • Olivia Pagani
    • 1
    • 2
    Email author
  • Shari Gelber
    • 3
  • Edda Simoncini
    • 4
  • Monica Castiglione-Gertsch
    • 5
  • Karen N. Price
    • 6
    • 7
    Email author
  • Richard D. Gelber
    • 3
  • Stig B. Holmberg
    • 8
  • Diana Crivellari
    • 9
  • John Collins
    • 10
  • Jurij Lindtner
    • 11
  • Beat Thürlimann
    • 12
  • Martin F. Fey
    • 13
  • Elizabeth Murray
    • 14
  • John F. Forbes
    • 15
  • Alan S. Coates
    • 16
  • Aron Goldhirsch
    • 17
    • 18
  • for the International Breast Cancer Study Group
    • 19
  1. 1.Oncology Institute of Southern SwitzerlandViganelloSwitzerland
  2. 2.Swiss Group for Clinical Cancer Research (SAKK)BernSwitzerland
  3. 3.IBCSG Statistical CenterDana-Farber Cancer Institute and Frontier Science and Technology Research FoundationBostonUSA
  4. 4.Oncologia Medica-Spedali CiviliBresciaItaly
  5. 5.IBCSG Coordinating CenterBernSwitzerland
  6. 6.IBCSG Statistical Center and Frontier Science and Technology Research FoundationBostonUSA
  7. 7.Department of Biostatistics and Computational BiologyDana Farber Cancer InstituteBostonUSA
  8. 8.Department of SurgerySahlgrenska University HospitalGoteborgSweden
  9. 9.Centro di Riferimento OncologicoAvianoItaly
  10. 10.Department of SurgeryThe Royal Melbourne HospitalMelbourneAustralia
  11. 11.The Institute of OncologyLjubljanaSlovenia
  12. 12.Senology Center of Eastern SwitzerlandSwiss Group for Clinical Cancer Research (SAKK), KantonsspitalSt. GallenSwitzerland
  13. 13.Department of Medical OncologySwiss Group for Clinical Cancer Research (SAKK), InselspitalBernSwitzerland
  14. 14.Groote Shuur HospitalUniversity of Cape TownCape TownSouth Africa
  15. 15.Australian New Zealand Breast Cancer Trials GroupUniversity of NewcastleNewcastleAustralia
  16. 16.International Breast Cancer Study GroupUniversity of SydneySydneyAustralia
  17. 17.Department of MedicineEuropean Institute of OncologyMilanItaly
  18. 18.Oncology Institute of Southern SwitzerlandBellinzonaSwitzerland
  19. 19.BernSwitzerland

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