Long-term results of International Breast Cancer Study Group Trial VIII: Adjuvant chemotherapy plus goserelin compared with either therapy alone for premenopausal patients with node-negative breast cancer Full Text
Annals of Oncology, 02/21/2011
Clinical Article
Karlsson P et al. – For pre/perimenopausal women with lymph-node-negative ER-positive breast cancer, CMF followed by goserelin improved DFS in comparison with either modality alone. The improvement was the most pronounced in those aged below 40, suggesting an endocrine effect of prolonged CMF-induced amenorrhea.
Methods- From 1990 to 1999, 1063 patients randomized to receive (i) goserelin for 24 months (n = 346), (ii) 6 courses of ‘classical’ CMF (cyclophosphamide, methotrexate, 5-fluorouracil) chemotherapy (n = 360), or (iii) 6 courses of CMF plus 18 months goserelin (CMF? goserelin; n = 357)
- Tumors classified as estrogen receptor (ER) negative (19%), ER positive (80%), or ER unknown (1%)
- 19% of patients younger than 40
- Median follow-up 12.1 years
- For ER-positive cohort, sequential therapy provided statistically significant benefit in DFS (12-year DFS = 77%) compared with CMF alone (69%) and goserelin alone (68%) (P = 0.04 for each comparison), due largely to effect in younger patients
- Patients with ER-negative tumors whose treatment included CMF had similar DFS (12-year DFS CMF = 67%; 12-year DFS CMF? goserelin = 69%) compared with goserelin alone (12-year DFS = 61%, P = NS)
