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Efficacy of neoadjuvant endocrine therapy compared with neoadjuvant chemotherapy in pre-menopausal patients with oestrogen receptor-positive and HER2-negative, lymph node-positive breast cancer

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dc.contributor.authorKim, Hee Jeong-
dc.contributor.authorNoh, Woo Chul-
dc.contributor.authorLee, Eun Sook-
dc.contributor.authorJung, Yong Sik-
dc.contributor.authorKim, Lee Su-
dc.contributor.authorHan, Wonshik-
dc.contributor.authorNam, Seok Jin-
dc.contributor.authorGong, Gyung-Yub-
dc.contributor.authorKim, Hwa Jung-
dc.contributor.authorAhn, Sei Hyun-
dc.date.accessioned2020-07-20T05:05:22Z-
dc.date.available2020-07-20T14:06:14Z-
dc.date.issued2020-05-27-
dc.identifier.citationBreast Cancer Research. 2020 May 27;22(1):54ko_KR
dc.identifier.issn1465-542X-
dc.identifier.urihttps://hdl.handle.net/10371/168613-
dc.description.abstractIntroduction
Neoadjuvant endocrine therapy (NET) has demonstrated efficacy in post-menopausal patients with hormone-responsive breast cancer. This trial was designed to compare the efficacy of neoadjuvant chemotherapy (NCT) with NET in pre-menopausal breast cancer.

Patients and methods
In this prospective, randomised, phase III study, oestrogen receptor (ER)-positive, HER2-negative, and lymph node-positive pre-menopausal breast cancer patients were recruited from 7 hospitals in South Korea. Enrolled patients were randomly assigned (1:1) to receive 24 weeks of either NCT or NET with goserelin and tamoxifen. The primary purpose was to evaluate the non-inferiority of NET compared to NCT using clinical response, assessed by MRI. Besides, pathological complete response rate (pCR), changes in Ki-67 expression, breast conservation surgery (BCS) rate, and quality of life were included as secondary endpoints.

Results
A total of 187 patients were assigned to receive NCT (n = 95) or NET (n = 92), and 87 patients in each group completed treatments. More NCT patients had complete response or partial response than NET patients using MRI (NCT 83.7% vs. NET 52.9%, 95% CI 17.6–44.0, p < 0.001) and callipers (NCT 83.9% vs. NET 71.3%, 95% CI 0.4–24.9, p = 0.046). Three NCT patients (3.4%) and one NET patient (1.2%) showed pCR (p < 0.005). No difference existed in the conversion rate of BCS (13.8% for NCT vs. 11.5% for NET, p = 0.531) and Ki-67 change (p = 0.114) between the two groups. Nineteen NCT patients had treatment-related grade 3 or worse events compared with none in the NET group.

Conclusions
Better clinical responses were observed in pre-menopausal patients after 24 weeks of NCT compared to those observed after NET.

Trial registration
Clinicaltrials.gov, NCT01622361. Registration June 19, 2012.
ko_KR
dc.description.sponsorshipThis work was supported by the AstraZeneca Korea.ko_KR
dc.language.isoenko_KR
dc.publisherBMCko_KR
dc.titleEfficacy of neoadjuvant endocrine therapy compared with neoadjuvant chemotherapy in pre-menopausal patients with oestrogen receptor-positive and HER2-negative, lymph node-positive breast cancerko_KR
dc.typeArticleko_KR
dc.contributor.AlternativeAuthor김희정-
dc.contributor.AlternativeAuthor노우철-
dc.contributor.AlternativeAuthor이은숙-
dc.contributor.AlternativeAuthor정용식-
dc.contributor.AlternativeAuthor김리수-
dc.contributor.AlternativeAuthor한우식-
dc.contributor.AlternativeAuthor남석진-
dc.contributor.AlternativeAuthor공경엽-
dc.identifier.doi10.1186/s13058-020-01288-5-
dc.citation.journaltitleBreast Cancer Researchko_KR
dc.language.rfc3066en-
dc.rights.holderThe Author(s)-
dc.date.updated2020-06-16T09:39:00Z-
dc.citation.number1ko_KR
dc.citation.startpage54ko_KR
dc.citation.volume22ko_KR
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