Impact of premenopausal status at breast cancer diagnosis in women entered on the placebo-controlled NCIC CTG MA17 trial of extended adjuvant letrozole

P. E. Goss, J. N. Ingle, S. Martino, N. J. Robert, H. B. Muss, R. B. Livingston, N. E. Davidson, E. A. Perez, Y. Chavarri-Guerra, D. A. Cameron, K. I. Pritchard, T. Whelan, L. E. Shepherd, D. Tu

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58 Scopus citations

Abstract

Background: MA17 showed improved outcomes in postmenopausal women given extended letrozole (LET) after completing 5 years of adjuvant tamoxifen. Patients and methods: Exploratory subgroup analyses of disease-free survival (DFS), distant DFS (DDFS), overall survival (OS), toxic effects and of life (QOL) in MA17 were performed based on menopausal status atquality breast cancer diagnosis. Results: At diagnosis, 877 women were premenopausal and 4289 were postmenopausal. Extended LET was significantly better than placebo (PLAC) in DFS for premenopausal [hazard ratio (HR) = 0.26, 95% confidence interval (CI) 0.13-0.55; P = 0.0003] and postmenopausal women (HR = 0.67; 95% CI 0.51-0.89; P = 0.006), with greater DFS benefit in those premenopausal (interaction P = 0.03). In adjusted post-unblinding analysis, those who switched from PLAC to LET improved DDFS in premenopausal (HR = 0.15; 95% CI 0.03-0.79; P = 0.02) and postmenopausal women (HR = 0.45; 95% CI 0.22-0.94; P = 0.03). Conclusions: Extended LET after 5 years of tamoxifen was effective in pre- and postmenopausal women at diagnosis, and significantly better in those premenopausal. Women premenopausal at diagnosis should be considered for extended adjuvant therapy with LET if menopausal after completing tamoxifen.

Original languageEnglish (US)
Article numbermds330
Pages (from-to)355-361
Number of pages7
JournalAnnals of Oncology
Volume24
Issue number2
DOIs
StatePublished - Feb 2013

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Keywords

  • Adjuvant therapy
  • Aromatase inhibitors
  • Breast cancer
  • Extended therapy
  • Letrozole
  • Menopausal status

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Goss, P. E., Ingle, J. N., Martino, S., Robert, N. J., Muss, H. B., Livingston, R. B., Davidson, N. E., Perez, E. A., Chavarri-Guerra, Y., Cameron, D. A., Pritchard, K. I., Whelan, T., Shepherd, L. E., & Tu, D. (2013). Impact of premenopausal status at breast cancer diagnosis in women entered on the placebo-controlled NCIC CTG MA17 trial of extended adjuvant letrozole. Annals of Oncology, 24(2), 355-361. [mds330]. https://doi.org/10.1093/annonc/mds330