The prognostic and predictive value of the luminal-like subtype in hormone receptor-positive breast cancer: an analysis of the DATA trial

IF 8.3 2区医学 Q1 ONCOLOGY ESMO Open Pub Date : 2025-02-01 Epub Date: 2025-02-07 DOI:10.1016/j.esmoop.2025.104154

S.W.M. Lammers , S.M.E. Geurts , K.E.P.E. Hermans , L.F.S. Kooreman , A.C.P. Swinkels , C.H. Smorenburg , M.J.C. van der Sangen , J.R. Kroep , A.H. Honkoop , F.W.P.J. van den Berkmortel , W.K. de Roos , S.C. Linn , A.L.T. Imholz , I.J.H. Vriens , V.C.G. Tjan-Heijnen , Dutch Breast Cancer Research Group (BOOG) for the DATA investigators

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Abstract

Background

This study determines the prognostic value of the luminal-like subtype in patients with hormone receptor-positive breast cancer and explores whether the efficacy of extended anastrozole therapy differs between patients with luminal A-like versus luminal B-like tumours.

Materials and methods

The phase III DATA study (NCT00301457) examined the efficacy of 6 versus 3 years of anastrozole in postmenopausal women with early-stage hormone receptor-positive breast cancer who had received 2-3 years of tamoxifen. Patients with available formalin-fixed paraffin-embedded tissue blocks were identified and classified by immunohistochemical luminal-like subtype. Distant recurrence (DR) and breast cancer-specific mortality (BCSM) were compared by luminal-like subtype and treatment arm using competing risk methods.

Results

This study included 788 patients: 491 had a luminal A-like tumour and 297 had a luminal B-like tumour. The median follow-up time was 13.1 years. Patients with luminal B-like tumours experienced a higher risk of DR [subdistribution hazard ratio (sHR) 1.44, 95% confidence interval (CI) 1.03-2.01, P = 0.03] and BCSM (sHR 1.68, 95% CI 1.15-2.45, P = 0.008) than patients with luminal A-like tumours. The efficacy of extended anastrozole therapy differed between patients with luminal A-like tumours (DR: sHR 0.51, 95% CI 0.30-0.88, P = 0.02; BCSM: sHR 0.39, 95% CI 0.19-0.82, P = 0.01) and patients with luminal B-like tumours (DR: sHR 2.09, 95% CI 0.96-4.53, P = 0.06; BCSM: sHR 2.36, 95% CI 0.80-7.00, P = 0.12) (P-interaction = 0.03 and P-interaction = 0.06, respectively).

Conclusion

In patients with hormone receptor-positive breast cancer, the luminal B-like subtype was associated with a significantly worse prognosis when compared with the luminal A-like subtype. Extended anastrozole therapy halved the risk of DR and BCSM in patients with luminal A-like tumours, whereas no effect was seen in patients with luminal B-like tumours.

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激素受体阳性乳腺癌中发光样亚型的预后和预测价值：数据试验分析

本研究确定了光腔样亚型在激素受体阳性乳腺癌患者中的预后价值，并探讨了延长阿纳曲唑治疗在管腔a样和管腔b样肿瘤患者中的疗效是否不同。材料和方法III期数据研究（NCT00301457）检验了阿纳曲唑对接受2-3年他莫昔芬治疗的绝经后早期激素受体阳性乳腺癌妇女6年和3年的疗效。采用免疫组织化学发光样亚型对可用的福尔马林固定石蜡包埋组织块患者进行鉴定和分类。采用竞争风险法比较光样亚型和治疗组的远处复发（DR）和乳腺癌特异性死亡率（BCSM）。结果本研究共纳入788例患者，其中491例为腔内a样肿瘤，297例为腔内b样肿瘤。中位随访时间为13.1年。腔内b样肿瘤患者发生DR（亚分布风险比（sHR） 1.44, 95%可信区间（CI） 1.03 ~ 2.01, P = 0.03）和BCSM （sHR 1.68, 95% CI 1.15 ~ 2.45, P = 0.008）的风险高于腔内a样肿瘤患者。延长阿那曲唑治疗在腔内a样肿瘤患者间的疗效差异(DR: sHR 0.51, 95% CI 0.30-0.88, P = 0.02；BCSM: sHR 0.39, 95% CI 0.19-0.82, P = 0.01)和腔内b样肿瘤患者(DR: sHR 2.09, 95% CI 0.96-4.53, P = 0.06；BCSM: sHR 2.36, 95% CI 0.80-7.00, P = 0.12) （P-interaction = 0.03, P-interaction = 0.06）。结论在激素受体阳性乳腺癌患者中，腔腔b样亚型与腔腔a样亚型相比，预后明显差。延长阿那曲唑治疗可使腔内a样肿瘤患者发生DR和BCSM的风险减半，而对腔内b样肿瘤患者则无效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ESMO Open Medicine-Oncology

CiteScore

11.70

自引率

2.70%

发文量

255

审稿时长

10 weeks

期刊介绍： ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research. ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO. Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.