Summary
156 patients with advanced breast cancer of known estrogen receptor (ER) and progesterone receptor (PgR) status treated by endocrine therapy were studied. Regarding values for ER and PgR ⩾ 5 fmole/mg cytosol protein as positive, patients were divided into 4 phenotypic subgroups: ER+PgR+ (43%), ER+PgR− (26%), ER−PgR+ (8%), and ER−PgR− (23%). In patients with tumor phenotype ER+PgR+, responses were seen in 20/30 (67%) assessable initial treatments when receptor assays were performed on tumor recurrence or on primary tumor immediately before endocrine therapy, and in only 11/32 (34%) assessable initial treatments when receptor analysis was performed on primary tumor and there was intervening local therapy before endocrine therapy was started for tumor recurrence (P<0.05).
Responses to first endocrine therapy for each tumor phenotype were ER+PgR+ 50%, ER+PgR− 27%, ER−PgR+ 27%, and ER−PgR− 6%. Four of 16 (25%) patients with ER+PgR+ tumors responded to subsequent secondary endocrine therapy, but such responses were not observed in 20 patients with other tumor phenotypes.
Duration of response was similar for each phenotype, but patients with ER−PgR− tumors had a significantly shorter survival from time of initial endocrine treatment than patients of any other phenotype.
These results suggest that repeat steroid receptor assays on accessible tumor immediately before endocrine therapy may result in improved predictability.
References
Dao TL, Nemoto T: Steroid receptors and response to endocrine ablations in women with metastatic cancer of the breast. Cancer 46: 2779–2782, 1980
Horwitz KB, McGuire WL, Pearson OH, Segaloff A: Predicting response to endocrine therapy in human breast cancer: a hypothesis. Science 189: 726–727, 1975
Skinner LG, Barnes DM, Ribeiro GG: The clinical value of multiple steroid receptor assays in breast cancer management. Cancer 46: 2939–2945, 1980
Young PCM, Ehrlich CE, Einhorn LH: Relationship between steroid receptors and response to endocrine therapy and cytotoxic chemotherapy in metastatic breast cancer. Cancer 46: 2961–2963, 1980
Osborne CK, McGuire WL: Current use of steroid hormone receptor assays in the treatment of breast cancer. Surg Clin North Am 58: 777–788, 1978
Manni A, Arafah B, Pearson OH: Estrogen and progesterone receptors in the prediction of response of breast cancer to endocrine therapy. Cancer 46: 2838–2841, 1980
DeSombre ER, Carbone PP, Jensen EV, McGuire WL, Wells SA, Wittliff JL, Lipsett MB: Steroid receptors in breast cancer. N Engl J Med 301: 1011–1012, 1979
Osborne CK, Yochmowitz MG, Knight WA, McGuire WL: The value of estrogen and progesterone receptors in the treatment of breast cancer. Cancer 46: 2884–2888, 1980
Rosen PP, Menendez-Botet CJ, Urban JA, Fracchia A, Schwartz MK: Estrogen receptor protein (ERP) in multiple tumor specimens from individual patients with breast cancer. Cancer 39: 2194–2200, 1977
King RJB: Analysis of estradiol and progesterone receptors in early and advanced breast tumors. Cancer 46: 2818–2821, 1980
Webster DJT, Bronn DG, Minton JP: Estrogen receptor levels in multiple biopsies from patients with breast cancer. Am J Surg 136: 337–338, 1978
Rubens RD, Stewart JF, King RJB, Minton MJ, Sparrow GEA, Knight RK: Primary endocrine therapy + prednisolone in advanced breast cancer (Abstract). Proc Amer Assoc Clin Oncol 22: 436, 1981
Hayward JL, Carbone PP, Heuson JC, Kumaoka S, Segaloff A, Rubens RD: Assessment of response to therapy in advanced breast cancer. Europ J Cancer 13: 89–94, 1977
Peto R, Pike MC, Armitage P, Bresloco NE, Cox DR, Howard SV, Mantel N, McPherson K, Peto J, Smith PG: Design and analysis of randomised clinical trials requiring prolonged observation of each patient. Brit J Cancer 35: 1–39, 1977
King RJB, Redgrave S, Hayward JL, Millis RR, Rubens RD: The measurement of receptors for oestradiol and progesterone in human breast tumors.In RJB King (ed): Steroid Receptor Assays in Breast Tumors: Methodological and Clinical Aspects. Alpha Omega Publishing Ltd, Cardiff, 1979, pp 55–72
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Address for reprints: Dr R.D. Rubens, Imperial Cancer Research Fund, Breast Cancer Unit, Guy's Hospital, London SE1 9RT, United Kingdom.
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Stewart, J., King, R., Hayward, J. et al. Estrogen and progesterone receptors: Correlation of response rates, site and timing of receptor analysis. Breast Cancer Res Tr 2, 243–250 (1982). https://doi.org/10.1007/BF01806937
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DOI: https://doi.org/10.1007/BF01806937