Ovarian function recovery in breast cancer patients receiving adjuvant anastrozole treatment: updated results from the phase 3 DATA trial.

IF 3 3区 医学 Q2 ONCOLOGY Breast Cancer Research and Treatment Pub Date : 2024-11-01 Epub Date: 2024-06-28 DOI:10.1007/s10549-024-07411-w
Senna W M Lammers, Sandra M E Geurts, Karlijn E P E Hermans, Irene E G van Hellemond, Astrid C P Swinkels, Carolien H Smorenburg, Maurice J C van der Sangen, Judith R Kroep, Aafke H Honkoop, Franchette W P J van den Berkmortel, Wilfred K de Roos, Alexander L T Imholz, Ingeborg J H Vriens, Vivianne C G Tjan-Heijnen
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Abstract

Purpose: Patients with chemotherapy-induced ovarian function failure (CIOFF) may experience ovarian function recovery (OFR). Earlier, we showed that OFR during treatment with anastrozole impacted the prognosis of hormone receptor-positive (HR+) breast cancer (BC) patients with CIOFF. Here, we present the long-term follow-up results.

Methods: Postmenopausal women with HR+ BC who were 45-57 years of age and received chemotherapy were identified from the phase 3 DATA study (NCT00301457) on the extended use of anastrozole. Eligible patients were categorised into two groups: patients with CIOFF and definitely postmenopausal patients. Patients with CIOFF were monitored for OFR. Disease-free survival (DFS), distant recurrence-free survival (DRFS), and overall survival (OS) were compared between patients with OFR and patients without OFR using multivariable Cox regression analyses, including OFR as a time-dependent covariate. BC-specific mortality (BCSM) was compared between groups using the Fine and Gray method.

Results: This study included 656 patients: 395 patients with CIOFF and 261 definitely postmenopausal patients. OFR occurred in 39 (12%) of 329 patients with CIOFF who were monitored for OFR. The median follow-up time was 13.3 years. Patients with OFR experienced a deterioration in DFS (hazard ratio (HR) = 1.54; 95% confidence interval (CI) 0.85-2.81), DRFS (HR = 1.51; 95% CI 0.73-3.11), OS (HR = 1.64; 95% CI 0.75-3.55), and BCSM (subdistribution HR = 1.98; 95% CI 0.84-4.63) when compared with patients without OFR.

Conclusion: In patients with CIOFF, OFR during treatment with anastrozole was associated with a deterioration in BC outcomes. These findings underscore the importance of adequate ovarian function suppression in this subgroup of patients.

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接受阿那曲唑辅助治疗的乳腺癌患者卵巢功能恢复情况:DATA 3 期试验的最新结果。
目的:化疗引起的卵巢功能衰竭(CIOFF)患者可能会出现卵巢功能恢复(OFR)。早些时候,我们发现阿那曲唑治疗期间的卵巢功能恢复会影响激素受体阳性(HR+)乳腺癌(BC)患者的预后。在此,我们介绍长期随访结果:方法:从关于延长阿那曲唑用药时间的 3 期 DATA 研究(NCT00301457)中筛选出 45-57 岁、接受过化疗的 HR+ BC 绝经后女性患者。符合条件的患者被分为两组:CIOFF 患者和绝经后患者。对CIOFF患者进行OFR监测。使用多变量 Cox 回归分析比较了有 OFR 和无 OFR 患者的无病生存期(DFS)、无远处复发生存期(DRFS)和总生存期(OS),并将 OFR 作为时间依赖性协变量。采用Fine和Gray方法比较了不同组间的BC特异性死亡率(BCSM):本研究共纳入 656 名患者:结果:该研究纳入了 656 名患者:395 名 CIOFF 患者和 261 名绝经后患者。在接受 OFR 监测的 329 名 CIOFF 患者中,有 39 人(12%)发生了 OFR。中位随访时间为 13.3 年。与未发生 OFR 的患者相比,发生 OFR 的患者的 DFS(危险比 (HR) = 1.54;95% 置信区间 (CI) 0.85-2.81)、DRFS(HR = 1.51;95% CI 0.73-3.11)、OS(HR = 1.64;95% CI 0.75-3.55)和 BCSM(亚分布 HR = 1.98;95% CI 0.84-4.63)均有所恶化:结论:在CIOFF患者中,阿那曲唑治疗期间的OFR与BC预后的恶化有关。这些发现强调了充分抑制卵巢功能对这部分患者的重要性。
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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
342
审稿时长
1 months
期刊介绍: Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.
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