Breast cancer: are long-term and intermittent endocrine therapies equally effective?
Breast cancer
Long-term endocrine adjuvant therapy
Metastasis
Over-treatment
Survival
Journal
Journal of cancer research and clinical oncology
ISSN: 1432-1335
Titre abrégé: J Cancer Res Clin Oncol
Pays: Germany
ID NLM: 7902060
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
03
04
2020
accepted:
14
05
2020
pubmed:
31
5
2020
medline:
14
7
2020
entrez:
31
5
2020
Statut:
ppublish
Résumé
In breast cancer (BC), the duration of endocrine adjuvant therapies (AT) has been extended continuously up to 10 years. We present an alternative explanation for the effect, which could enable shorter treatments. The relevant literature on chemoprevention and (neo-)adjuvant therapy was reviewed. Data for initiation and growth of primary and contralateral BCs and their metastases (MET) were considered. Also, population-based data from the Munich Cancer Registry for MET-free survival, time trends of MET patterns, and survival achieved by improved ATs are used to estimate all events in the long-term follow-up. Extended ATs (EAT) that continue after 1, 2, or 5 years reduce mortality only slightly. The effect is delayed, occurring more than 5 years after extension. EATs does not affect the prognosis of 1stBCs, they preventively eradicate contralateral 2ndBCs and thus their future life-threatening METs. Because chemoprevention can eradicate BCs from the smallest clusters to almost detectable BCs, ATs can be temporarily suspended without imposing harm. Results equal to EATs can be achieved by short-term ATs of the 1stBC and by repeated neo-ATs targeted at the indefinitely developing 2ndBCs. Considering this potential in de-escalation, a 70-80% reduction of overtreatment seems possible. Knowledge of initiation and growth of tumors with known effects of neo-ATs suggest that intermittent endocrine ATs may achieve the same results as EATs but with improved quality of life and survival because of fewer side effects and better compliance. The challenge for developments of repeated ATs becomes: how short is short enough.
Identifiants
pubmed: 32472445
doi: 10.1007/s00432-020-03264-0
pii: 10.1007/s00432-020-03264-0
pmc: PMC7324413
doi:
Substances chimiques
Antineoplastic Agents, Hormonal
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2041-2049Références
Bartlett JMS et al (2019) Breast Cancer Index and prediction of benefit from extended endocrine therapy in breast cancer patients treated in the Adjuvant Tamoxifen-To Offer More? (aTTom) trial. Ann Oncol 30:1776–1783. https://doi.org/10.1093/annonc/mdz289
doi: 10.1093/annonc/mdz289
pubmed: 31504126
pmcid: 6927322
Blok EJ et al (2018) Optimal duration of extended adjuvant endocrine therapy for early breast cancer; results of the IDEAL trial (BOOG 2006–05). J Natl Cancer Inst. https://doi.org/10.1093/jnci/djx134
doi: 10.1093/jnci/djx134
pubmed: 28922787
Burstein HJ et al (2019) Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. ASCO Clin Pract Guidel Focus Update J Clin Oncol 37:423–438. https://doi.org/10.1200/jco.18.01160
doi: 10.1200/jco.18.01160
Cameron D et al (2017) 11 years’ follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive early breast cancer: final analysis of the HERceptin Adjuvant (HERA) trial. Lancet 389:1195–1205. https://doi.org/10.1016/s0140-6736(16)32616-2
doi: 10.1016/s0140-6736(16)32616-2
pubmed: 28215665
pmcid: 5465633
Cardoso F et al (2019) Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-updagger. Ann Oncol 30:1194–1220. https://doi.org/10.1093/annonc/mdz173
doi: 10.1093/annonc/mdz173
pubmed: 31161190
Chaudary MA, Millis RR, Hoskins EO, Halder M, Bulbrook RD, Cuzick J, Hayward JL (1984) Bilateral primary breast cancer: a prospective study of disease incidence. Br J Surg 71:711–714
doi: 10.1002/bjs.1800710924
Chen Y, Thompson W, Semenciw R, Mao Y (1999) Epidemiology of contralateral breast cancer. Cancer Epidemiol Biomark Prev 8:855–861
Colleoni M et al (2018) Extended adjuvant intermittent letrozole versus continuous letrozole in postmenopausal women with breast cancer (SOLE): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 19:127–138. https://doi.org/10.1016/s1470-2045(17)30715-5
doi: 10.1016/s1470-2045(17)30715-5
pubmed: 29158011
Cuzick J, Sestak I, Baum M, Buzdar A, Howell A, Dowsett M, Forbes JF (2010) Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 10-year analysis of the ATAC trial. Lancet Oncol 11:1135–1141. https://doi.org/10.1016/s1470-2045(10)70257-6
doi: 10.1016/s1470-2045(10)70257-6
pubmed: 21087898
Cuzick J, Sestak I, Cawthorn S, Hamed H, Holli K, Howell A, Forbes JF (2015) Tamoxifen for prevention of breast cancer: extended long-term follow-up of the IBIS-I breast cancer prevention trial. Lancet Oncol 16:67–75. https://doi.org/10.1016/s1470-2045(14)71171-4
doi: 10.1016/s1470-2045(14)71171-4
pubmed: 25497694
pmcid: 4772450
Davies C et al (2013) Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet 381:805–816. https://doi.org/10.1016/s0140-6736(12)61963-1
doi: 10.1016/s0140-6736(12)61963-1
pubmed: 23219286
pmcid: 3596060
Delozier T et al (2000) Delayed adjuvant tamoxifen: ten-year results of a collaborative randomized controlled trial in early breast cancer (TAM-02 trial). Ann Oncol 11:515–519
doi: 10.1023/A:1008321415065
DeMichele A, Yee D, Esserman L (2017) Mechanisms of resistance to neoadjuvant chemotherapy in breast cancer. N Engl J Med 377:2287–2289. https://doi.org/10.1056/NEJMcibr1711545
doi: 10.1056/NEJMcibr1711545
pubmed: 29211674
Early Breast Cancer Trialists’ Collaborative Group (1992) Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. 133 randomised trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Early Breast Cancer Trial Collabor Group Lancet 339:1–15
Early Breast Cancer Trialists’ Collaborative Group (1998) Tamoxifen for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trial Collabor Group Lancet 351:1451–1467
Early Breast Cancer Trialists’ Collaborative Group (2011) Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 378:771–784. https://doi.org/10.1016/S0140-6736(11)60993-8
doi: 10.1016/S0140-6736(11)60993-8
Early Breast Cancer Trialists’ Collaborative Group (2015) Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials. Lancet 386:1341–1352. https://doi.org/10.1016/s0140-6736(15)61074-1
doi: 10.1016/s0140-6736(15)61074-1
Ekholm M, Bendahl PO, Ferno M, Nordenskjold B, Stal O, Ryden L (2016) Two years of adjuvant tamoxifen provides a survival benefit compared with no systemic treatment in premenopausal patients with primary breast cancer: long-term follow-up (> 25 years) of the Phase III SBII:2pre Trial. J Clin Oncol 34:2232–2238. https://doi.org/10.1200/jco.2015.65.6272
doi: 10.1200/jco.2015.65.6272
pubmed: 27161974
Engel J, Weichert W, Jung A, Emeny R, Holzel D (2019) Lymph node infiltration, parallel metastasis and treatment success in breast cancer. Breast (Edinburgh, Scotland) 48:1–6. https://doi.org/10.1016/j.breast.2019.07.008
doi: 10.1016/j.breast.2019.07.008
Gagliato DDM et al (2014) Clinical impact of delaying initiation of adjuvant chemotherapy in patients with breast cancer. J Clin Oncol 32:735–744. https://doi.org/10.1200/jco.2013.49.7693
doi: 10.1200/jco.2013.49.7693
pmcid: 3940536
Gierach GL et al (2016) Association of adjuvant tamoxifen and aromatase inhibitor therapy with contralateral breast cancer risk among US women with breast cancer in a general community setting. JAMA Oncol. https://doi.org/10.1001/jamaoncol.2016.3340
doi: 10.1001/jamaoncol.2016.3340
pubmed: 27711920
pmcid: 5757540
Gnant M, Steger G, Greil R (2018) A prospective randomized multi-center phase-III trial of additional 2 versus additional 5 years of anastrozole after initial 5 years of adjuvant endocrine therapy—results from 3,484 postmenopausal women in the ABCSG-16 trial [abstract]. Cancer Res 78(4 Suppl):Abstract nr GS3-01
Goss PE et al (2016) Extending aromatase-inhibitor adjuvant therapy to 10 years. N Engl J Med 375:209–219. https://doi.org/10.1056/nejmoa1604700
doi: 10.1056/nejmoa1604700
pubmed: 27264120
pmcid: 5024713
Gray RG (2013) Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6,953 women with early breast cancer. J Clin Oncol 31:5
doi: 10.1200/jco.2013.31.15_suppl.5
Harbeck N et al (2019) Breast cancer. Nat Rev Dis Prim 5:66. https://doi.org/10.1038/s41572-019-0111-2
doi: 10.1038/s41572-019-0111-2
pubmed: 31548545
Hölzel D, Eckel R, Emeny R, Engel J (2010) Distant metastases do not metastasize. Cancer metastasis reviews 29:737–750. https://doi.org/10.1007/s10555-010-9260-1
doi: 10.1007/s10555-010-9260-1
pubmed: 20878451
Hölzel D et al (2017) Improved systemic treatment for early breast cancer improves cure rates, modifies metastatic pattern and shortens post-metastatic survival: 35-year results from the Munich Cancer Registry. J Cancer Res Clin Oncol 143:1701–1712. https://doi.org/10.1007/s00432-017-2428-0
doi: 10.1007/s00432-017-2428-0
pubmed: 28429102
Jordan VC, Allen KE (1980) Evaluation of the antitumour activity of the non-steroidal antioestrogen monohydroxytamoxifen in the DMBA-induced rat mammary carcinoma model. Eur J Cancer (Oxford, England : 1990) 16:239–251
doi: 10.1016/0014-2964(80)90156-5
Mamounas EP et al (2019) Use of letrozole after aromatase inhibitor-based therapy in postmenopausal breast cancer (NRG Oncology/NSABP B-42): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 20:88–99. https://doi.org/10.1016/s1470-2045(18)30621-1
doi: 10.1016/s1470-2045(18)30621-1
pubmed: 30509771
Metcalfe K et al (2004) Contralateral breast cancer in BRCA1 and BRCA2 mutation carriers. J Clin Oncol 22:2328–2335. https://doi.org/10.1200/jco.2004.04.033
doi: 10.1200/jco.2004.04.033
pubmed: 15197194
Michailidou K et al (2017) Association analysis identifies 65 new breast cancer risk loci. Nature. https://doi.org/10.1038/nature24284
doi: 10.1038/nature24284
pubmed: 29059683
pmcid: 5798588
Munich Cancer Registry http://www.tumorregister-muenchen.de/en/ . Accessed 25 May 2020
Noone A, Howlader N, Krapcho M, Miller D, Brest Ae SEER Cancer Statistics Review, 1975–2015 National Cancer Institute. Bethesda, MD. http://seer.cancer.gov/ . Accessed 25 May 2020
Pan H et al (2017) 20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years. N Engl J Med 377:1836–1846. https://doi.org/10.1056/nejmoa1701830
doi: 10.1056/nejmoa1701830
pubmed: 29117498
pmcid: 5734609
Rutqvist LE, Johansson H (2007) Long-term follow-up of the randomized Stockholm trial on adjuvant tamoxifen among postmenopausal patients with early stage breast cancer. Acta Oncol (Stockholm, Sweden) 46:133–145. https://doi.org/10.1080/02841860601034834
doi: 10.1080/02841860601034834
Smith IE, Yeo B, Schiavon G (2014) The optimal duration and selection of adjuvant endocrine therapy for breast cancer: how long is enough? Am Soc Clin Oncol Educ Book:e16–24. https://doi.org/10.14694/edbook_am.2014.34.e16
Swedish Breast Cancer Cooperative Group (1996) Randomized trial of two versus five years of adjuvant tamoxifen for postmenopausal early stage breast cancer. Swed Breast Cancer Cooper Group J Natl Cancer Inst 88:1543–1549
doi: 10.1093/jnci/88.21.1543
Veronesi A, Miolo G, Magri MD, Crivellari D, Scalone S, Bidoli E, Lombardi D (2010) Late tamoxifen in patients previously operated for breast cancer without postoperative tamoxifen: 5-year results of a single institution randomised study. BMC Cancer 10:205. https://doi.org/10.1186/1471-2407-10-205
doi: 10.1186/1471-2407-10-205
pubmed: 20470379
pmcid: 2882922
Weedon-Fekjaer H, Lindqvist BH, Vatten LJ, Aalen OO, Tretli S (2008) Breast cancer tumor growth estimated through mammography screening data. BCR 10:R41. https://doi.org/10.1186/bcr2092
doi: 10.1186/bcr2092
pubmed: 18466608
Welch HG, Prorok PC, O’Malley AJ, Kramer BS (2016) Breast-cancer tumor size, overdiagnosis, and mammography screening effectiveness. N Engl J Med 375:1438–1447. https://doi.org/10.1056/NEJMoa1600249
doi: 10.1056/NEJMoa1600249
pubmed: 27732805
Yates LR et al (2017) Genomic evolution of breast cancer metastasis and relapse. Cancer Cell 32:169–184.e167. https://doi.org/10.1016/j.ccell.2017.07.005
doi: 10.1016/j.ccell.2017.07.005
pubmed: 28810143
pmcid: 5559645
Yung R et al (2020) The association of delay in curative intent treatment with survival among breast cancer patients: findings from the Women’s Health Initiative. Breast Cancer Res Treat. https://doi.org/10.1007/s10549-020-05572-y
doi: 10.1007/s10549-020-05572-y
pubmed: 32062784