Breast cancer: ER+ and PR+ fare worse than ER+PR+ patients

  • Wu N & al.
  • Clin Transl Oncol
  • 20 Jun 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Patients with breast cancer who are single hormone receptor-positive (ER+PR or ERPR+) have worse DFS, breast cancer-specific survival (BCSS), OS, and recurrence than patients who are double-positive (ER+PR+).

Why this matters

  • ER+PR or ERPR+ tumors may require more aggressive treatment than ER+PR+ tumors.

Study design

  • Meta-analysis of 22 studies (n=217,485 women) after a search of Google Scholar and the Cochrane database.
  • Most of the 22 studies were of stage I-III breast cancer.
  • Funding: National Nature Science Foundation of China; others.

Key results

  • Worse DFS (vs ER+PR+):
    • ER+PR: HR, 1.60; 95% CI, 1.44-1.77.
    • ERPR+: HR, 2.27; 95% CI, 1.67-3.09.
  • Worse BCSS (vs ER+PR+):
    • ER+PR: HR, 1.43; 95% CI, 1.33-1.53.
    • ERPR+: HR, 1.82; 95% CI, 1.68-1.98.
  • Worse OS (vs ER+PR+)
    • ER+PR: HR, 1.38; 95% CI, 1.28-1.47.
    • ERPR+: HR, 1.48; 95% CI, 1.17-1.89.
  • Worse risk for recurrence in the following subgroups (ER+PR vs ER+PR+):
    • HER2 subgroup: HR, 1.57; 95% CI, 1.32-1.87.
    • Lymph node-negative subgroup: HR, 2.03; 95% CI, 1.44-2.86.
    • Endocrine therapy-positive subgroup: HR, 1.65; 95% CI, 1.45-1.89.
  • Worse DFS in subgroup with HER2/ERPR+ (vs HER2/ER+PR+): HR, 3.10; 95% CI, 1.92-5.10.

Limitation

  • Study design of individual studies not specified.

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