OFS plus AI or SERM vs. SERM alone in premenopausal women with hormone receptor-positive breast cancer: a prospective cohort study using the real-world database
Background Ovarian function suppression (OFS) plus other endocrine treatment was recommended to hormone receptor (HR)-positive breast cancer by some guidelines recently. We performed this study to validate the survival benefits of OFS plus aromatase inhibitors (AI) or selective estrogen receptor mod...
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| Veröffentlicht in: | Breast cancer (Tokyo, Japan) Japan), 2019-05, Vol.26 (3), p.339-348 |
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| container_title | Breast cancer (Tokyo, Japan) |
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| creator | Hu, Kejia He, Ping Peng, Qian Zhong, Xiaorong Deng, Ling Xie, Yuxin Li, Jiayuan Xu, Hongping Lu, Donghao Zheng, Hong |
| description | Background
Ovarian function suppression (OFS) plus other endocrine treatment was recommended to hormone receptor (HR)-positive breast cancer by some guidelines recently. We performed this study to validate the survival benefits of OFS plus aromatase inhibitors (AI) or selective estrogen receptor modulators (SERM) in the real world.
Methods
All premenopausal, HR-positive breast cancer patients diagnosed between 1996 and 2017 were identified. Eligible patients were classified into three groups according to their adjuvant endocrine treatment, including OFS plus AI, OFS plus SERM and SERM alone. The primary outcome is invasive disease-free survival (iDFS), whereas the secondary outcome is overall survival (OS). Cox proportional hazards models and propensity score adjusted models were used to compare the survival benefits in three groups.
Results
We included 2838 patients, of which 246 received OFS plus AI, 175 received OFS plus SERM, and 2417 received SERM alone. Compared with SERM alone, OFS plus AI was associated with an improved iDFS (HR 0.59, 95% CI 0.36–0.96) and OS (HR 0.26, 95% CI 0.08–0.85). OFS plus SERM, however, was not significantly associated with extended iDFS or OS. Among patients older than 40 years old, OFS plus AI was more effective than OFS plus SERM (HR 0.38, 95% CI 0.17–0.88) or SERM alone (HR 0.44, 95% CI 0.23–0.84) in terms of iDFS.
Conclusions
Our findings suggest that OFS plus AI treatment may extend both iDFS and OS among premenopausal patients with hormone receptor-positive breast cancer in the real world. |
| doi_str_mv | 10.1007/s12282-018-0929-6 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_484552</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A712280399</galeid><sourcerecordid>A712280399</sourcerecordid><originalsourceid>FETCH-LOGICAL-c473t-3d9100d5464bea538628fb922578754b999806bb4cd4fbdd8d053a26a9daf8503</originalsourceid><addsrcrecordid>eNp9klFv1SAYhhujcXP6A7wxJN540yMFSsG7k2XTJTNLnF4TCl_PYbalAt3J_o0_VWqPS0yM4YIPeN4v8PIWxesKbyqMm_exIkSQEleixJLIkj8pTishcMkIpU9zTRkuueDipHgR4x3GjDaYPy9OKKa8obU4LX7eXN6iqZ8j2l4hH9DtxZfP6D5u1kL3fgTkRjQFGGD0k56j7tHB5wU6uLRHex-GhQlgYEo-lJOPLrl7QG0AHRMyejQQPiCde_g4gfl9aHwWJhTTbB_QHN24Q2m_dNF9efCht8jqpFsd4WXxrNN9hFfH-az4dnnx9fxTeX3z8ep8e10a1tBUUiuzJbZmnLWgayo4EV0rCakb0dSslVIKzNuWGcu61lphcU014Vpa3Yka07OiXPvGA0xzq6bgBh0elNdOHbe-5woUE6yuSebfrXx-1o8ZYlKDiwb6Xo_g56hIRbiseCNoRt-u6E73oNzY-RS0WXC1bZYvxFTKTG3-QeVhYXAme9y5vP-XoFoFJhsbA3SPd66wWvKh1nyonA-15EPxrHlzvPXcDmAfFX8CkQFytCEfjTsI6s7PYczO_6frL3LfxiU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2126916783</pqid></control><display><type>article</type><title>OFS plus AI or SERM vs. SERM alone in premenopausal women with hormone receptor-positive breast cancer: a prospective cohort study using the real-world database</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Hu, Kejia ; He, Ping ; Peng, Qian ; Zhong, Xiaorong ; Deng, Ling ; Xie, Yuxin ; Li, Jiayuan ; Xu, Hongping ; Lu, Donghao ; Zheng, Hong</creator><creatorcontrib>Hu, Kejia ; He, Ping ; Peng, Qian ; Zhong, Xiaorong ; Deng, Ling ; Xie, Yuxin ; Li, Jiayuan ; Xu, Hongping ; Lu, Donghao ; Zheng, Hong</creatorcontrib><description>Background
Ovarian function suppression (OFS) plus other endocrine treatment was recommended to hormone receptor (HR)-positive breast cancer by some guidelines recently. We performed this study to validate the survival benefits of OFS plus aromatase inhibitors (AI) or selective estrogen receptor modulators (SERM) in the real world.
Methods
All premenopausal, HR-positive breast cancer patients diagnosed between 1996 and 2017 were identified. Eligible patients were classified into three groups according to their adjuvant endocrine treatment, including OFS plus AI, OFS plus SERM and SERM alone. The primary outcome is invasive disease-free survival (iDFS), whereas the secondary outcome is overall survival (OS). Cox proportional hazards models and propensity score adjusted models were used to compare the survival benefits in three groups.
Results
We included 2838 patients, of which 246 received OFS plus AI, 175 received OFS plus SERM, and 2417 received SERM alone. Compared with SERM alone, OFS plus AI was associated with an improved iDFS (HR 0.59, 95% CI 0.36–0.96) and OS (HR 0.26, 95% CI 0.08–0.85). OFS plus SERM, however, was not significantly associated with extended iDFS or OS. Among patients older than 40 years old, OFS plus AI was more effective than OFS plus SERM (HR 0.38, 95% CI 0.17–0.88) or SERM alone (HR 0.44, 95% CI 0.23–0.84) in terms of iDFS.
Conclusions
Our findings suggest that OFS plus AI treatment may extend both iDFS and OS among premenopausal patients with hormone receptor-positive breast cancer in the real world.</description><identifier>ISSN: 1340-6868</identifier><identifier>EISSN: 1880-4233</identifier><identifier>DOI: 10.1007/s12282-018-0929-6</identifier><identifier>PMID: 30367358</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Adult ; Analysis ; Antineoplastic Agents, Hormonal - pharmacology ; Antineoplastic Agents, Hormonal - therapeutic use ; Antineoplastic Combined Chemotherapy Protocols - pharmacology ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Aromatase Inhibitors - pharmacology ; Aromatase Inhibitors - therapeutic use ; Breast Neoplasms - metabolism ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Breast Neoplasms - therapy ; Cancer ; Cancer Research ; Combined Modality Therapy ; Disease-Free Survival ; Estrogen ; Female ; Goserelin - pharmacology ; Goserelin - therapeutic use ; Hormones ; Humans ; Medicine ; Medicine & Public Health ; Menopause ; Middle Aged ; Oncology ; Oncology, Experimental ; Original Article ; Ovariectomy ; Ovary - drug effects ; Ovary - physiopathology ; Ovary - surgery ; Premenopause ; Prospective Studies ; Receptors, Estrogen - metabolism ; Receptors, Progesterone - metabolism ; Selective Estrogen Receptor Modulators - pharmacology ; Selective Estrogen Receptor Modulators - therapeutic use ; Surgery ; Surgical Oncology ; Survival Rate ; Women</subject><ispartof>Breast cancer (Tokyo, Japan), 2019-05, Vol.26 (3), p.339-348</ispartof><rights>The Japanese Breast Cancer Society 2018</rights><rights>COPYRIGHT 2019 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-3d9100d5464bea538628fb922578754b999806bb4cd4fbdd8d053a26a9daf8503</citedby><cites>FETCH-LOGICAL-c473t-3d9100d5464bea538628fb922578754b999806bb4cd4fbdd8d053a26a9daf8503</cites><orcidid>0000-0001-5802-330X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12282-018-0929-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12282-018-0929-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30367358$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:140781234$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Hu, Kejia</creatorcontrib><creatorcontrib>He, Ping</creatorcontrib><creatorcontrib>Peng, Qian</creatorcontrib><creatorcontrib>Zhong, Xiaorong</creatorcontrib><creatorcontrib>Deng, Ling</creatorcontrib><creatorcontrib>Xie, Yuxin</creatorcontrib><creatorcontrib>Li, Jiayuan</creatorcontrib><creatorcontrib>Xu, Hongping</creatorcontrib><creatorcontrib>Lu, Donghao</creatorcontrib><creatorcontrib>Zheng, Hong</creatorcontrib><title>OFS plus AI or SERM vs. SERM alone in premenopausal women with hormone receptor-positive breast cancer: a prospective cohort study using the real-world database</title><title>Breast cancer (Tokyo, Japan)</title><addtitle>Breast Cancer</addtitle><addtitle>Breast Cancer</addtitle><description>Background
Ovarian function suppression (OFS) plus other endocrine treatment was recommended to hormone receptor (HR)-positive breast cancer by some guidelines recently. We performed this study to validate the survival benefits of OFS plus aromatase inhibitors (AI) or selective estrogen receptor modulators (SERM) in the real world.
Methods
All premenopausal, HR-positive breast cancer patients diagnosed between 1996 and 2017 were identified. Eligible patients were classified into three groups according to their adjuvant endocrine treatment, including OFS plus AI, OFS plus SERM and SERM alone. The primary outcome is invasive disease-free survival (iDFS), whereas the secondary outcome is overall survival (OS). Cox proportional hazards models and propensity score adjusted models were used to compare the survival benefits in three groups.
Results
We included 2838 patients, of which 246 received OFS plus AI, 175 received OFS plus SERM, and 2417 received SERM alone. Compared with SERM alone, OFS plus AI was associated with an improved iDFS (HR 0.59, 95% CI 0.36–0.96) and OS (HR 0.26, 95% CI 0.08–0.85). OFS plus SERM, however, was not significantly associated with extended iDFS or OS. Among patients older than 40 years old, OFS plus AI was more effective than OFS plus SERM (HR 0.38, 95% CI 0.17–0.88) or SERM alone (HR 0.44, 95% CI 0.23–0.84) in terms of iDFS.
Conclusions
Our findings suggest that OFS plus AI treatment may extend both iDFS and OS among premenopausal patients with hormone receptor-positive breast cancer in the real world.</description><subject>Adult</subject><subject>Analysis</subject><subject>Antineoplastic Agents, Hormonal - pharmacology</subject><subject>Antineoplastic Agents, Hormonal - therapeutic use</subject><subject>Antineoplastic Combined Chemotherapy Protocols - pharmacology</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Aromatase Inhibitors - pharmacology</subject><subject>Aromatase Inhibitors - therapeutic use</subject><subject>Breast Neoplasms - metabolism</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - therapy</subject><subject>Cancer</subject><subject>Cancer Research</subject><subject>Combined Modality Therapy</subject><subject>Disease-Free Survival</subject><subject>Estrogen</subject><subject>Female</subject><subject>Goserelin - pharmacology</subject><subject>Goserelin - therapeutic use</subject><subject>Hormones</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Menopause</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Oncology, Experimental</subject><subject>Original Article</subject><subject>Ovariectomy</subject><subject>Ovary - drug effects</subject><subject>Ovary - physiopathology</subject><subject>Ovary - surgery</subject><subject>Premenopause</subject><subject>Prospective Studies</subject><subject>Receptors, Estrogen - metabolism</subject><subject>Receptors, Progesterone - metabolism</subject><subject>Selective Estrogen Receptor Modulators - pharmacology</subject><subject>Selective Estrogen Receptor Modulators - therapeutic use</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>Women</subject><issn>1340-6868</issn><issn>1880-4233</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9klFv1SAYhhujcXP6A7wxJN540yMFSsG7k2XTJTNLnF4TCl_PYbalAt3J_o0_VWqPS0yM4YIPeN4v8PIWxesKbyqMm_exIkSQEleixJLIkj8pTishcMkIpU9zTRkuueDipHgR4x3GjDaYPy9OKKa8obU4LX7eXN6iqZ8j2l4hH9DtxZfP6D5u1kL3fgTkRjQFGGD0k56j7tHB5wU6uLRHex-GhQlgYEo-lJOPLrl7QG0AHRMyejQQPiCde_g4gfl9aHwWJhTTbB_QHN24Q2m_dNF9efCht8jqpFsd4WXxrNN9hFfH-az4dnnx9fxTeX3z8ep8e10a1tBUUiuzJbZmnLWgayo4EV0rCakb0dSslVIKzNuWGcu61lphcU014Vpa3Yka07OiXPvGA0xzq6bgBh0elNdOHbe-5woUE6yuSebfrXx-1o8ZYlKDiwb6Xo_g56hIRbiseCNoRt-u6E73oNzY-RS0WXC1bZYvxFTKTG3-QeVhYXAme9y5vP-XoFoFJhsbA3SPd66wWvKh1nyonA-15EPxrHlzvPXcDmAfFX8CkQFytCEfjTsI6s7PYczO_6frL3LfxiU</recordid><startdate>20190501</startdate><enddate>20190501</enddate><creator>Hu, Kejia</creator><creator>He, Ping</creator><creator>Peng, Qian</creator><creator>Zhong, Xiaorong</creator><creator>Deng, Ling</creator><creator>Xie, Yuxin</creator><creator>Li, Jiayuan</creator><creator>Xu, Hongping</creator><creator>Lu, Donghao</creator><creator>Zheng, Hong</creator><general>Springer Japan</general><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><orcidid>https://orcid.org/0000-0001-5802-330X</orcidid></search><sort><creationdate>20190501</creationdate><title>OFS plus AI or SERM vs. SERM alone in premenopausal women with hormone receptor-positive breast cancer: a prospective cohort study using the real-world database</title><author>Hu, Kejia ; He, Ping ; Peng, Qian ; Zhong, Xiaorong ; Deng, Ling ; Xie, Yuxin ; Li, Jiayuan ; Xu, Hongping ; Lu, Donghao ; Zheng, Hong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-3d9100d5464bea538628fb922578754b999806bb4cd4fbdd8d053a26a9daf8503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Analysis</topic><topic>Antineoplastic Agents, Hormonal - pharmacology</topic><topic>Antineoplastic Agents, Hormonal - therapeutic use</topic><topic>Antineoplastic Combined Chemotherapy Protocols - pharmacology</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Aromatase Inhibitors - pharmacology</topic><topic>Aromatase Inhibitors - therapeutic use</topic><topic>Breast Neoplasms - metabolism</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - therapy</topic><topic>Cancer</topic><topic>Cancer Research</topic><topic>Combined Modality Therapy</topic><topic>Disease-Free Survival</topic><topic>Estrogen</topic><topic>Female</topic><topic>Goserelin - pharmacology</topic><topic>Goserelin - therapeutic use</topic><topic>Hormones</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Menopause</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Oncology, Experimental</topic><topic>Original Article</topic><topic>Ovariectomy</topic><topic>Ovary - drug effects</topic><topic>Ovary - physiopathology</topic><topic>Ovary - surgery</topic><topic>Premenopause</topic><topic>Prospective Studies</topic><topic>Receptors, Estrogen - metabolism</topic><topic>Receptors, Progesterone - metabolism</topic><topic>Selective Estrogen Receptor Modulators - pharmacology</topic><topic>Selective Estrogen Receptor Modulators - therapeutic use</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hu, Kejia</creatorcontrib><creatorcontrib>He, Ping</creatorcontrib><creatorcontrib>Peng, Qian</creatorcontrib><creatorcontrib>Zhong, Xiaorong</creatorcontrib><creatorcontrib>Deng, Ling</creatorcontrib><creatorcontrib>Xie, Yuxin</creatorcontrib><creatorcontrib>Li, Jiayuan</creatorcontrib><creatorcontrib>Xu, Hongping</creatorcontrib><creatorcontrib>Lu, Donghao</creatorcontrib><creatorcontrib>Zheng, Hong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><jtitle>Breast cancer (Tokyo, Japan)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hu, Kejia</au><au>He, Ping</au><au>Peng, Qian</au><au>Zhong, Xiaorong</au><au>Deng, Ling</au><au>Xie, Yuxin</au><au>Li, Jiayuan</au><au>Xu, Hongping</au><au>Lu, Donghao</au><au>Zheng, Hong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>OFS plus AI or SERM vs. SERM alone in premenopausal women with hormone receptor-positive breast cancer: a prospective cohort study using the real-world database</atitle><jtitle>Breast cancer (Tokyo, Japan)</jtitle><stitle>Breast Cancer</stitle><addtitle>Breast Cancer</addtitle><date>2019-05-01</date><risdate>2019</risdate><volume>26</volume><issue>3</issue><spage>339</spage><epage>348</epage><pages>339-348</pages><issn>1340-6868</issn><eissn>1880-4233</eissn><abstract>Background
Ovarian function suppression (OFS) plus other endocrine treatment was recommended to hormone receptor (HR)-positive breast cancer by some guidelines recently. We performed this study to validate the survival benefits of OFS plus aromatase inhibitors (AI) or selective estrogen receptor modulators (SERM) in the real world.
Methods
All premenopausal, HR-positive breast cancer patients diagnosed between 1996 and 2017 were identified. Eligible patients were classified into three groups according to their adjuvant endocrine treatment, including OFS plus AI, OFS plus SERM and SERM alone. The primary outcome is invasive disease-free survival (iDFS), whereas the secondary outcome is overall survival (OS). Cox proportional hazards models and propensity score adjusted models were used to compare the survival benefits in three groups.
Results
We included 2838 patients, of which 246 received OFS plus AI, 175 received OFS plus SERM, and 2417 received SERM alone. Compared with SERM alone, OFS plus AI was associated with an improved iDFS (HR 0.59, 95% CI 0.36–0.96) and OS (HR 0.26, 95% CI 0.08–0.85). OFS plus SERM, however, was not significantly associated with extended iDFS or OS. Among patients older than 40 years old, OFS plus AI was more effective than OFS plus SERM (HR 0.38, 95% CI 0.17–0.88) or SERM alone (HR 0.44, 95% CI 0.23–0.84) in terms of iDFS.
Conclusions
Our findings suggest that OFS plus AI treatment may extend both iDFS and OS among premenopausal patients with hormone receptor-positive breast cancer in the real world.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>30367358</pmid><doi>10.1007/s12282-018-0929-6</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-5802-330X</orcidid></addata></record> |
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| subjects | Adult Analysis Antineoplastic Agents, Hormonal - pharmacology Antineoplastic Agents, Hormonal - therapeutic use Antineoplastic Combined Chemotherapy Protocols - pharmacology Antineoplastic Combined Chemotherapy Protocols - therapeutic use Aromatase Inhibitors - pharmacology Aromatase Inhibitors - therapeutic use Breast Neoplasms - metabolism Breast Neoplasms - mortality Breast Neoplasms - pathology Breast Neoplasms - therapy Cancer Cancer Research Combined Modality Therapy Disease-Free Survival Estrogen Female Goserelin - pharmacology Goserelin - therapeutic use Hormones Humans Medicine Medicine & Public Health Menopause Middle Aged Oncology Oncology, Experimental Original Article Ovariectomy Ovary - drug effects Ovary - physiopathology Ovary - surgery Premenopause Prospective Studies Receptors, Estrogen - metabolism Receptors, Progesterone - metabolism Selective Estrogen Receptor Modulators - pharmacology Selective Estrogen Receptor Modulators - therapeutic use Surgery Surgical Oncology Survival Rate Women |
| title | OFS plus AI or SERM vs. SERM alone in premenopausal women with hormone receptor-positive breast cancer: a prospective cohort study using the real-world database |
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