Breast cancer: adding estrogen deprivation to NACT boosts response

  • Yu KD & al.
  • Cancer
  • 20 Mar 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Addition of estrogen deprivation via endocrine therapy (ET) to neoadjuvant chemotherapy (NACT) significantly improved response rates in a trial of patients with stage IIb-IIIc estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer.
  • PFS benefit observed in patients with higher baseline Ki-67 index.

Why this matters

  • Findings suggest that estrogen deprivation with ET should be routinely added to NACT, particularly if baseline Ki-67 is higher.

Study design

  • Randomized, controlled CBCSG-036 trial (n=249) of patients given NACT alone or NACT plus letrozole (an aromatase inhibitor) if postmenopausal, or letrozole plus leuprorelin if premenopausal.
  • Funding: National Natural Science Foundation of China; others.

Key results

  • Median follow-up: 26 months.
  • Adding ET to NACT yielded a significantly higher objective response rate (ORR, 84.8% vs 72.6%; OR, 2.11; P=.020).
    • ORR benefit was even greater in subset with high (>20%) baseline Ki-67 index (91.2% vs 68.7%; P=.001).
  • No overall differences between groups in pathologic complete response, pathological response, and 2-year PFS.
  • In subanalysis, 2-year PFS benefit observed with ET+NACT vs NACT alone among patients with high Ki-67 index (91.5% vs 76.5%; P=.058).
  • No differences between groups in grade 3,4 adverse events.

Limitations

  • Open-label design.
  • Short duration of follow-up.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit