| Title |
Benefit from anthracyclines in relation to biological profiles in early breast cancer
|
|---|---|
| Published in |
Breast Cancer Research and Treatment, January 2014
|
| DOI | 10.1007/s10549-013-2819-0 |
| Pubmed ID | |
| Authors |
Andrea Rocca, Sara Bravaccini, Emanuela Scarpi, Anita Mangia, Stella Petroni, Maurizio Puccetti, Laura Medri, Luigi Serra, Monica Ricci, Serenella Cerasoli, Nicoletta Biglia, Roberta Maltoni, Donata Casadei Giunchi, Lorenzo Gianni, Amelia Tienghi, Mario Brandi, Monica Faedi, Piero Sismondi, Angelo Paradiso, Rosella Silvestrini, Dino Amadori |
| Abstract |
There are no validated predictors of benefit from anthracyclines. We compared cyclophosphamide, methotrexate, 5-fluorouracil (CMF), and epirubicin in different sequences with CMF alone in a phase III trial on operable breast cancers. Outcomes were analyzed in relation to tumor biological profiles to identify potential predictors of the efficacy of different treatments/drug combinations. Patients with N- or 1-3N+ tumors, were randomized to receive (a) epirubicin (4 cycles) followed by CMF (4 cycles); (b) CMF (4 cycles) followed by epirubicin (4 cycles), or (c) CMF (6 cycles) alone. Immunohistochemical assessments of estrogen (ER) and progesterone (PgR) receptors, HER2 and Ki67 were available for 705 patients (arm A/B/C: 276/269/160). Prognostic and predictive relevance was analyzed by log-rank tests and Cox models. Ki67 > 20 % and absent/low expression of ER and PgR were associated with worsen disease-free (DFS) and overall survival (OS). In patients with triple negative tumors (ER-, PgR-, HER2-), epirubicin-containing regimens yielded better DFS (HR 0.33, 95 % CI 0.17-0.62, P = 0.0007) and OS (HR 0.24, 95 % CI 0.10-0.57, P = 0.001) compared with CMF alone, whereas no differences were found in patients with HER2-positive (HER2+, ER-, PgR-) subtype. Treatment by subtype interaction (HER2-positive vs. others) was significant for DFS (χ (2) = 6.72, P = 0.009). In triple unfavorable (ER-, PgR-, Ki67 > 20 %) tumors, the use of epirubicin yielded better DFS (HR 0.45,95 % CI 0.26-0.78, P = 0.005) and OS (HR 0.30, 95 % CI 0.15-0.63, P = 0.001). Epirubicin-containing regimens seem to be superior to CMF alone in patients with highly proliferating, triple negative or triple unfavorable tumors. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 47 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 7 | 15% |
| Student > Master | 5 | 11% |
| Student > Ph. D. Student | 4 | 9% |
| Other | 3 | 6% |
| Professor | 3 | 6% |
| Other | 8 | 17% |
| Unknown | 17 | 36% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 17 | 36% |
| Nursing and Health Professions | 3 | 6% |
| Biochemistry, Genetics and Molecular Biology | 2 | 4% |
| Agricultural and Biological Sciences | 2 | 4% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
| Other | 2 | 4% |
| Unknown | 20 | 43% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 January 2014.
All research outputs
#18,359,382
of 22,738,543 outputs
Outputs from Breast Cancer Research and Treatment
#3,715
of 4,651 outputs
Outputs of similar age
#229,335
of 305,211 outputs
Outputs of similar age from Breast Cancer Research and Treatment
#45
of 54 outputs
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