| Title: |
Invasive disease-free and overall survival after (neo)adjuvant chemotherapy in postmenopausal patients with hormone receptor-positive, HER2-negative early breast cancer treated with upfront letrozole : experiences from the phase IV PreFace trial |
| Authors: |
Beierlein, Milena; Häberle, Lothar; Nabieva, Naiba; Maass, Nicolai; Aktas, Bahriye; Kümmel, Sherko; Thomssen, Christoph; Wolf, Christopher; Kolberg, Hans-Christian; Brucker, Cosima; Janni, Wolfgang; Dall, Peter; Schneeweiss, Andreas; Marmé, Frederik; Sütterlin, Marc; Ruebner, Matthias; Theuser, Anna-Katharin; Hofmann, Nadine M.; Böhm, Sybille; Almstedt, Katrin; Kellner, Sara; Gass, Paul; Lück, Hans-Joachim; Hein, Alexander; Schmatloch, Sabine; Kalder, Matthias; Uleer, Christoph; Juhasz-Böss, Ingolf; Hanf, Volker; Jackisch, Christian; Müller, Volkmar; Rack, Brigitte; Belleville, Erik; Wallwiener, Diethelm; Rody, Achim; Rauh, Claudia; Bayer, Chistian M.; Uhrig, Sabrina; Huebner, Hanna; Goossens, Chloë; Brucker, Sara; Hack, Carolin C.; Fehm, Tanja; Fasching, Peter Andreas |
| Publication Year: |
2025 |
| Collection: |
Share it - Open Access und Forschungsdaten-Repositorium der Hochschulbibliotheken in Sachsen-Anhalt |
| Subject Terms: |
ddc:610 |
| Description: |
Patients with hormone receptor-positive (HRpos), HER2-negative (HER2neg) breast cancer (BC) benefit less from neoadjuvant chemotherapy (NACT) than patients with triple-negative and HER2-positive BC. In this retrospective analysis of the phase IV PreFace clinical trial (NCT01908556), where postmenopausal HRpos BC patients (n = 3297) were treated with 5-year upfront adjuvant letrozole therapy, we evaluated the prognosis of patients treated with adjuvant versus neoadjuvant chemotherapy in HRpos/HER2neg early-stage BC. HRpos/HER2neg patients with information on (neo)adjuvant chemotherapy (n = 2895) were retrospectively selected from all patients enrolled in the PreFace trial. Invasive disease-free survival (iDFS) and overall survival (OS) were compared between patient groups that were treated with neoadjuvant or adjuvant chemotherapy. Chemotherapy was given to 1051 patients (36.3% of all patients), of which 874 (83.2%) received adjuvant chemotherapy and 177 (16.8%) NACT. Pathologic complete response (pCR) rate in the NACT group was 6.9%. Patients treated with NACT had a worse outcome than those treated with adjuvant chemotherapy (5-year iDFS rate 81% vs. 88%; 5-year OS rate 89% vs. 93%). This effect was maintained after adjusting for age, BMI, lymph node status, grading, tumor size, and histology (hazard ratio for iDFS: 1.95 (95%CI: 1.28-2.95); hazard ratio for OS: 2.13 (95%CI: 1.24-3.66)). Further adjustment for taxane-based regimes did not alter results. In conclusion, in this retrospective analysis of patients with early-stage HRpos/HER2neg BC, patients with NACT had a more unfavorable prognosis than patients treated adjuvantly, independent of patient and tumor characteristics. Prognosis of neoadjuvant patients might be affected by resistance mechanisms, warranting further investigation. ; Erstmals veröffentlicht: 11. Juli 2025 ; Gesehen am 28.08.2025 |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISBN: |
978-1-932452-36-5; 1-932452-36-2 |
| Relation: |
http://dx.doi.org/10.25673/120877 |
| DOI: |
10.25673/120877 |
| Availability: |
https://opendata.uni-halle.de//handle/1981185920/122833; https://doi.org/10.25673/120877 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.7BA69493 |
| Database: |
BASE |