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Kim YS, Shim EJ, Lee JW, Cho J, Jung HK, Kim NH, Lee JE, Min J, Noh WC, Park SH. Abstract P1-08-21: Association of depression and anxiety disorder with the risk of mortality in breast cancer: A national health insurance service study in South Korea. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-08-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
PURPOSE: To examine whether depression, anxiety disorder and their co-occurrence would increase the risk of mortality in patients with breast cancer, and whether antidepressant treatment would reduce the same.
PATIENTS AND METHODS: Data were retrieved from the database of the Korean National Health Insurance Service. Of 145,251 patients diagnosed with breast cancer between 2007 and 2014, 20,870 patients diagnosed with depression or anxiety disorder one year before breast cancer diagnosis were excluded. Thus, data of 124,381 patients were included in this study.
RESULTS: Anxiety disorder was more prevalent than depression in patients with breast cancer, and similar factors were associated with both depression and anxiety disorder. Overall, female sex, older age, residence in metropolitan areas, lower income, higher comorbidity, carcinoma in situ, and the receipt of any type of cancer therapies were associated with an increased risk of depression or anxiety disorder. Depression and anxiety disorder were associated with an increased risk of mortality (Hazard Ratio (HR) = 1.26, 95% CI=1.18–1.36; HR=1.14, 95% CI=1.08–1.22, respectively) and their co-occurrence further increased the risk (HR=1.38, 95% CI=1.24–1.54). Antidepressant treatment was related to a reduced risk of mortality. Compared to patients with no depression, among those with depression, the risk of mortality was 2.18 times higher (95% CI=1.69–2.81) in patients who did not receive antidepressant treatment and 1.25 times higher (95% CI =1.17–1.32) in those who received antidepressant treatment.
CONCLUSION: The current findings suggest that psychiatric comorbidities are markers of increased mortality risk in patients with breast cancer. This underscores the need for screening and treating depression and anxiety disorders to improve survival in breast cancer.
Citation Format: Kim YS, Shim E-J, Lee JW, Cho J, Jung HK, Kim NH, Lee JE, Min J, Noh WC, Park S-H. Association of depression and anxiety disorder with the risk of mortality in breast cancer: A national health insurance service study in South Korea [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-08-21.
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Affiliation(s)
- YS Kim
- Chosun University College of Medicine, Gwangju, Republic of Korea; Pusan National University, Busan, Republic of Korea; University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea; Seran General Hospital, Seoul, Republic of Korea; Kaywon University of Art and Design, Uiwang-si, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Dankook University College of Medicine, Cheonan, Republic of Korea; Korea Institute of Radiology and Medical Science, Korea Cancer Center Hospital, Seoul, Republic of Korea; Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - E-J Shim
- Chosun University College of Medicine, Gwangju, Republic of Korea; Pusan National University, Busan, Republic of Korea; University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea; Seran General Hospital, Seoul, Republic of Korea; Kaywon University of Art and Design, Uiwang-si, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Dankook University College of Medicine, Cheonan, Republic of Korea; Korea Institute of Radiology and Medical Science, Korea Cancer Center Hospital, Seoul, Republic of Korea; Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - JW Lee
- Chosun University College of Medicine, Gwangju, Republic of Korea; Pusan National University, Busan, Republic of Korea; University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea; Seran General Hospital, Seoul, Republic of Korea; Kaywon University of Art and Design, Uiwang-si, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Dankook University College of Medicine, Cheonan, Republic of Korea; Korea Institute of Radiology and Medical Science, Korea Cancer Center Hospital, Seoul, Republic of Korea; Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - J Cho
- Chosun University College of Medicine, Gwangju, Republic of Korea; Pusan National University, Busan, Republic of Korea; University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea; Seran General Hospital, Seoul, Republic of Korea; Kaywon University of Art and Design, Uiwang-si, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Dankook University College of Medicine, Cheonan, Republic of Korea; Korea Institute of Radiology and Medical Science, Korea Cancer Center Hospital, Seoul, Republic of Korea; Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - HK Jung
- Chosun University College of Medicine, Gwangju, Republic of Korea; Pusan National University, Busan, Republic of Korea; University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea; Seran General Hospital, Seoul, Republic of Korea; Kaywon University of Art and Design, Uiwang-si, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Dankook University College of Medicine, Cheonan, Republic of Korea; Korea Institute of Radiology and Medical Science, Korea Cancer Center Hospital, Seoul, Republic of Korea; Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - NH Kim
- Chosun University College of Medicine, Gwangju, Republic of Korea; Pusan National University, Busan, Republic of Korea; University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea; Seran General Hospital, Seoul, Republic of Korea; Kaywon University of Art and Design, Uiwang-si, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Dankook University College of Medicine, Cheonan, Republic of Korea; Korea Institute of Radiology and Medical Science, Korea Cancer Center Hospital, Seoul, Republic of Korea; Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - JE Lee
- Chosun University College of Medicine, Gwangju, Republic of Korea; Pusan National University, Busan, Republic of Korea; University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea; Seran General Hospital, Seoul, Republic of Korea; Kaywon University of Art and Design, Uiwang-si, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Dankook University College of Medicine, Cheonan, Republic of Korea; Korea Institute of Radiology and Medical Science, Korea Cancer Center Hospital, Seoul, Republic of Korea; Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - J Min
- Chosun University College of Medicine, Gwangju, Republic of Korea; Pusan National University, Busan, Republic of Korea; University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea; Seran General Hospital, Seoul, Republic of Korea; Kaywon University of Art and Design, Uiwang-si, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Dankook University College of Medicine, Cheonan, Republic of Korea; Korea Institute of Radiology and Medical Science, Korea Cancer Center Hospital, Seoul, Republic of Korea; Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - WC Noh
- Chosun University College of Medicine, Gwangju, Republic of Korea; Pusan National University, Busan, Republic of Korea; University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea; Seran General Hospital, Seoul, Republic of Korea; Kaywon University of Art and Design, Uiwang-si, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Dankook University College of Medicine, Cheonan, Republic of Korea; Korea Institute of Radiology and Medical Science, Korea Cancer Center Hospital, Seoul, Republic of Korea; Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - S-H Park
- Chosun University College of Medicine, Gwangju, Republic of Korea; Pusan National University, Busan, Republic of Korea; University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Keimyung University School of Medicine, Daegu, Republic of Korea; Seran General Hospital, Seoul, Republic of Korea; Kaywon University of Art and Design, Uiwang-si, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Dankook University College of Medicine, Cheonan, Republic of Korea; Korea Institute of Radiology and Medical Science, Korea Cancer Center Hospital, Seoul, Republic of Korea; Daegu Catholic University Medical Center, Daegu, Republic of Korea
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Kim HJ, Noh WC, Nam SJ, Park BW, Lee ES, Im SA, Jung YS, Yoon JH, Kang SS, Park KH, Lee SJ, Jung J, Lee MH, Cho SH, Kim SY, Kim HA, Han SH, Han W, Hur MH, Ahn SH. Abstract P4-14-04: Time course changes in serum FSH, estradiol, and menstruation restoration in premenopausal patients with breast cancer taking adjuvant tamoxifen after completing chemotherapy: A report from the ASTRRA study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-14-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND
Assessment of restoration of ovarian function after chemotherapy is critical with respect to the initiation of different types of endocrine treatment in young high risk breast cancer patients
METHODS
In total, 1289 women who remained premenopausal or resumed premenopausal status after chemotherapy were randomized to receive 5 years of tamoxifen or 5 years of tamoxifen plus 2 years of ovarian suppression. The patients who did not resume menstruation were followed up for 2 years with tamoxifen treatment after finishing chemotherapy. Prospectively collected consecutive post-chemotherapy hormone and menstruation data were available for 705 breast cancer patients who enrolled tamoxifen-only treatment group or did not resume menstruation during follow up. This analysis evaluated the proportion of patients with pre-menopausal FSH levels (<30 mIU/ml), E2 levels (340 pg/ml), and menstruation at any time point during treatment with tamoxifen.
RESULTS
During 5 years of tamoxifen treatment after chemotherapy for premenopausal breast cancer patients, 62% of patients resumed menstruation. Menstruation returned in 92% of patients under 35 years old but only in 31% of patients over 45 years old. Ovarian function, defined by serum FSH and E2 levels, resumed in 94% and 65% of patients, respectively, over 5 years. Most patients achieved ovarian function restoration during the first 2 years after chemotherapy, with 47.1% resuming menstruation and 86.2% and 50.3% achieving pre-menopausal FSH and E2 levels, respectively, in the first 2 years. Clinical factors related to menstruation restoration were younger age (HR = 6.38, 95% CI 1.33-3.47), 6 month hormone profile after chemotherapy (FSH<30: HR=1.67, 95% CI 1.28-2.17; E2 >40: HR=2.96, 95% CI 2.25-3.89), and anthracycline without taxane chemotherapy (HR=1.63, 95% CI 1.25-2.13).
CONCLUSIONS
During 5 years of tamoxifen treatment after chemotherapy, half of patients experienced menstruation restoration, including most very young patients under 35 years. The majority of patients experienced menstruation restoration in the first 2 years of tamoxifen treatment.
Citation Format: Kim HJ, Noh WC, Nam SJ, Park B-w, Lee ES, Im SA, Jung YS, Yoon JH, Kang SS, Park KH, Lee S-J, Jung J, Lee MH, Cho SH, Kim SY, Kim H-A, Han S-H, Han W, Hur MH, Ahn SH. Time course changes in serum FSH, estradiol, and menstruation restoration in premenopausal patients with breast cancer taking adjuvant tamoxifen after completing chemotherapy: A report from the ASTRRA study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-14-04.
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Affiliation(s)
- HJ Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - WC Noh
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SJ Nam
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - B-w Park
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - ES Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SA Im
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - YS Jung
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - JH Yoon
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SS Kang
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - KH Park
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - S-J Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - J Jung
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - MH Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SH Cho
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SY Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - H-A Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - S-H Han
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - W Han
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - MH Hur
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SH Ahn
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
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Toyama T, Jeong J, Srimuninnimit V, Sriuranpong V, Noh W, Tsugawa K, Takahashi M, Iwase H, Arce C, Ridolfi A, Lin C, Royce M, Cardoso F. Everolimus (EVE) + letrozole (LET) in Asian patients with estrogen receptor–positive (ER+), human epidermal growth factor receptor 2–negative (HER2−) advanced breast cancer (ABC): Results of a subgroup analysis from the BOLERO-4 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Villanueva C, Tsugawa K, Toyama T, Noh W, Jeong J, Cardoso F, Sriuranpong V, Srimuninnimit V, Ozguroglu M, Kendall S, Falkson C, Cianfrocca M, Manlius C, Lin JCJ, Ringeisen F, Ridolfi A, Royce M. Abstract P2-11-08: Stomatitis in patients treated with first-line everolimus (EVE) plus letrozole (LET): Results from BOLERO-4 trial. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-11-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Stomatitis is the most frequent adverse event reported in trials of mTOR-inhibitors, including EVE. In the pivotal phase 3 BOLERO-2 study, stomatitis incidence in the EVE + exemestane (EXE) arm was 59%. The BOLERO-4 study (NCT01698918) evaluated the efficacy and safety of first-line EVE + LET in postmenopausal pts with HR+, HER2− metastatic or locally advanced breast cancer (ABC). BOLERO-4 also assessed the effectiveness of an alcohol-free dexamethasone (0.5 mg/ 5ml; DEX) oral rinse for treating stomatitis in a subset of pts (USA).
Methods
Postmenopausal pts with HR+, HER2− ABC previously untreated for advanced disease received EVE (10 mg/day) + LET (2.5 mg/day).At disease progression, pts were offered EVE (10 mg/day) + EXE (25 mg/day). Pts who had at least one episode of stomatitis received oral stomatitis daily questionnaire (OSDQ), which is a 6 question pt-reported outcome (PRO) survey (Stiff et al, JCO. 2006). A subset of these pts (USA) was randomized (1:1) to receive DEX or standard of care (SOC). The primary objective of investigator-assessed progression-free survival in the first-line setting for ABC was presented previously. A secondary objective was to evaluate the effectiveness of the DEX oral rinse in reducing the severity and duration of stomatitis, using OSDQ data.
Results
Of the total 202 pts enrolled in this study, 52 pts were enrolled in USA, of which, 24 (46.2%) were randomized to receive DEX (n=11) or SOC (n=13), upon confirmation of stomatitis. The median duration of first stomatitis episode was longer per OSDQ (DEX, not estimable vs SOC, 13.7 wk) compared with physician-reported duration (DEX, 1.6 wk vs SOC, 1.9 wk). PRO OSDQ results were similar in both arms.
Among the 202 pts enrolled, 89 (44.1%) filled the OSDQ at their first stomatitis episode. The median time from treatment initiation to first stomatitis episode was 1.7 wk; median duration of stomatitis was 13.7 wk (OSDQ) vs 2.1 wk (physician reported). The majority of pts experiencing stomatitis had moderate/little/no soreness, moderate/low/no pain, and stomatitis had low/no effect on daily activities (Table 1).
Table 1. OSDQ Key Results (N=87)Questions (Score)First Day of Stomatitis Episode, n (%)End of First Stomatitis Episode, n (%)Overall healthPoor (0-4)20 (23.0)23 (26.4)Moderate (5-7)40 (46.0)32 (36.8)Perfect (8-10)27 (31.0)32 (36.8)Mouth and throat sorenessNo/a little/moderate (0-2)64 (73.6)84 (96.6)A lot or extreme (3-4)23 (26.4)3 (3.4)Mouth pain severityNo/low/moderate (0-4)51 (58.6)73 (83.9)Severe (5-7)24 (27.6)10 (11.5)Unbearable (8-10)12 (13.8)4 (4.6)Effect on daily activitiesNo/low (0-4)70 (80.5)78 (89.7)Moderate (5-7)11 (12.6)4 (4.6)High (8-10)6 (6.9)5 (5.7)
Conclusions
Overall, patient-reported median duration of stomatitis was longer than that reported by physicians, most likely due to differences in perceptions and the challenges in collecting and cleaning PRO data. Overall good health score was maintained in the majority of pts experiencing stomatitis and stomatitis had low/no effect on daily activities. However, these results, especially in the randomized subset need to be interpreted with caution owing to the small sample size, missing data and lack of commercially available DEX in most countries.
Citation Format: Villanueva C, Tsugawa K, Toyama T, Noh W, Jeong J, Cardoso F, Sriuranpong V, Srimuninnimit V, Ozguroglu M, Kendall S, Falkson C, Cianfrocca M, Manlius C, Lin JCJ, Ringeisen F, Ridolfi A, Royce M. Stomatitis in patients treated with first-line everolimus (EVE) plus letrozole (LET): Results from BOLERO-4 trial [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-11-08.
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Affiliation(s)
- C Villanueva
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - K Tsugawa
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - T Toyama
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - W Noh
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - J Jeong
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - F Cardoso
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - V Sriuranpong
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - V Srimuninnimit
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - M Ozguroglu
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - S Kendall
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - C Falkson
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - M Cianfrocca
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - C Manlius
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - JCJ Lin
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - F Ringeisen
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - A Ridolfi
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - M Royce
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
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Kim HJ, Ahn SH, Nam SJ, Park SH, Ro JS, Im SA, Jung YS, Noh WC. Abstract P5-12-08: Time course of changes in serum FSH, serum estradiol, and menstruation in premenopausal patients with breast cancer taking tamoxifen after completing chemotherapy: A report from the ASTRRA study. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-12-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND
Ovarian suppression with tamoxifen after chemotherapy is a promising therapeutic approach, particularly in young, high-risk breast cancer patients. Assessment of restoration of ovarian function is important with respect to the initiation of ovarian suppression.
METHODS
In total, 1289 women who remained or resumed premenopausal status after chemotherapy were randomized to receive 5 years of tamoxifen or 5 years of tamoxifen plus 2 years of ovarian suppression. Prospectively collected hormone data were available for 24 months after completing chemotherapy for 267 breast cancer patients without ovarian suppression.
RESULTS
At 6 months, a premenopausal status was identified in 56.6%, 36%, and 16.2% of patients using serum FSH, E2, and with menstruation bleeding, respectively, and about 30% more women achieved ovarian restoration using all three parameters during the 24-month follow-up. Ovarian function restoration differed significantly according to age group (log-rank, P<0.001 for all definitions). At 6 months, the distribution of patients according to hormone levels was as follows: group 1 (FSH <30 mIU/ml, E2 >20 pg/ml), 28.0%; group 2 (FSH <30 mIU/ml, E2 ≤20 pg/ml), 28.4%; group 3 (FSH ≥30 mIU/ml, E2 >20 pg/ml), 8.0%; and group 4 (FSH ≥30 mIU/ml, E2 ≤20 pg/ml), 35.6%. During the 24-month follow-up, the prevalence of menstruation restoration was higher in group 1 (71.6%) than in the other three groups. Restoration of serum E2 and menstrual bleeding occurred in 44% and 33% of patients in group 2, respectively; the corresponding percentages in group 4 were 40.6% and 28.7% (P<0.001).
CONCLUSIONS
Ovarian function should be monitored using serum FSH, serum E2, and menstruation history for at least 24 months after completing chemotherapy during tamoxifen treatment to establish eligibility for ovarian suppression.
Citation Format: Kim HJ, Ahn SH, Nam SJ, Park SH, Ro JS, Im SA, Jung YS, Noh WC. Time course of changes in serum FSH, serum estradiol, and menstruation in premenopausal patients with breast cancer taking tamoxifen after completing chemotherapy: A report from the ASTRRA study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-12-08.
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Affiliation(s)
- HJ Kim
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Ajou University, School of Medicine, Suwon, Republic of Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - SH Ahn
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Ajou University, School of Medicine, Suwon, Republic of Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - SJ Nam
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Ajou University, School of Medicine, Suwon, Republic of Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - SH Park
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Ajou University, School of Medicine, Suwon, Republic of Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - JS Ro
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Ajou University, School of Medicine, Suwon, Republic of Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - SA Im
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Ajou University, School of Medicine, Suwon, Republic of Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - YS Jung
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Ajou University, School of Medicine, Suwon, Republic of Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - WC Noh
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Ajou University, School of Medicine, Suwon, Republic of Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
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Han S, Lee S, Noh W, Nam S, Kang S, Kim J, Bae Y, Park H, Cho S, Jung S, Yoon J, Park H, Jung Y, Kim L. Assessment of Quality of Life, Bmd and Safety Profiles in Postmenopausal Breas Cancer Patients with Letrozole As an Early Adjuvant Treatment (Kbcsg-008). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu327.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Blanquart T, Kaipio M, Niinistö J, Gavagnin M, Longo V, Blanquart L, Lansalot C, Noh W, Wanzenböck HD, Ritala M, Leskelä M. Cyclopentadienyl Precursors for the Atomic Layer Deposition of Erbium Oxide Thin Films. ACTA ACUST UNITED AC 2014. [DOI: 10.1002/cvde.201407116] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Timothee Blanquart
- Laboratory of Inorganic Chemistry, Department of Chemistry; University of Helsinki; P.O. Box 55 FI-00014 Helsinki (Finland)
| | - Mikko Kaipio
- Laboratory of Inorganic Chemistry, Department of Chemistry; University of Helsinki; P.O. Box 55 FI-00014 Helsinki (Finland)
| | - Jaakko Niinistö
- Laboratory of Inorganic Chemistry, Department of Chemistry; University of Helsinki; P.O. Box 55 FI-00014 Helsinki (Finland)
| | - Marco Gavagnin
- Institute for Solid State Electronics; Vienna University of Technology; A-1040 Vienna (Austria)
| | - Valentino Longo
- Department of Applied Physics; Technische Universiteit Eindhoven; P.O. Box 513 5600 MB Eindhoven (The Netherlands)
| | - Laurie Blanquart
- École nationale supérieure des arts et industries textiles; 9 rue de l'ermitage BP 30329 Roubaix (France)
| | - Clement Lansalot
- Air Liquide Korea; 11F Bojun Bldg., 70-13, Nonhyun-Dong, Gangnam-gu Seoul 135-530 (Korea)
| | - W. Noh
- Air Liquide Korea; 11F Bojun Bldg., 70-13, Nonhyun-Dong, Gangnam-gu Seoul 135-530 (Korea)
| | - Heinz D. Wanzenböck
- Institute for Solid State Electronics; Vienna University of Technology; A-1040 Vienna (Austria)
| | - Mikko Ritala
- Laboratory of Inorganic Chemistry, Department of Chemistry; University of Helsinki; P.O. Box 55 FI-00014 Helsinki (Finland)
| | - Markku Leskelä
- Laboratory of Inorganic Chemistry, Department of Chemistry; University of Helsinki; P.O. Box 55 FI-00014 Helsinki (Finland)
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Kim SI, Cho SH, Lee JS, Moon HG, Noh WC, Youn HJ, Ko BK, Park BW. Clinical relevance of lymph node ratio in breast cancer patients with one to three positive lymph nodes. Br J Cancer 2013; 109:1165-71. [PMID: 23942073 PMCID: PMC3778309 DOI: 10.1038/bjc.2013.465] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 07/16/2013] [Accepted: 07/21/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To test the hypotheses that breast cancer patients with one to three positive lymph nodes (pN1) consist of heterogeneous prognostic subsets and that the ratio of positive nodes to total nodes dissected (lymph node ratio, LNR) might discriminate patients with a higher risk as candidates for post-mastectomy radiation therapy (PMRT). METHODS Using information from 7741 node-positive patients, we first identified cutoff values of the LNR using the nonparametric bootstrap method. Focusing on 3477 patients with pN1 disease, we then evaluated the clinical relevance of the LNR categorised by the estimated cutoff values (categorised LNR, cLNR). RESULTS Among 3477 patients with pN1 disease, 3059 and 418 patients were assigned into the low and intermediate cLNR groups, respectively, based on a cutoff value of 0.18. The prognostic factors associated with poor overall survival (OS) included younger age, T2 stage, negative oestrogen/progesterone receptors, high histologic grade, and intermediate cLNR. Post-mastectomy radiation therapy significantly increased OS in patients assigned to the intermediate cLNR (hazard ratio, 0.39; 95% confidence interval, 0.17-0.89; P=0.0248), whereas patients in the low cLNR group derived no additional survival benefit from PMRT. CONCLUSION This study suggests that PMRT should be recommended for patients with pN1 disease and an intermediate cLNR.
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Affiliation(s)
- S I Kim
- Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
| | - S-H Cho
- Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-ro, Dongjak-gu, Seoul 156-743, Republic of Korea
| | - J S Lee
- Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
| | - H-G Moon
- Department of Surgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Republic of Korea
| | - W C Noh
- Department of Surgery, Korea Institute of Radiological and Medical Science, Gongneung-Dong, No-won-gu, Seoul 139-709, Republic of Korea
| | - H J Youn
- Department of Surgery, Chonbuk National University Medical School, 20 Geonjiro, Deokjin-gu, Jeonju 561-712, Republic of Korea
| | - B K Ko
- Department of Surgery, University of Ulsan College of Medicine, 877 Jeonha 1-dong, Dong-gu, Ulsan 682-714, Republic of Korea
| | - B-W Park
- Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
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Kim H, Ko E, Kim E, Jo E, Kim M, Noh W. The Early Prediction of Response to Neoadjuvant Chemotherapy Using MRI. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-6057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: Neoadjuvant chemotherapy is an effective method for down-staging the primary tumor before surgery. However, some of patients do not respond. In these patients, neoadjuvant chemotherapy is just an ineffective, toxic and expensive procedure. Therefore, it is very important to find the reliable method to differentiate the responder from non-responder as early as possible. In order to evaluate the role of magnetic resonance imaging (MRI) for the assessment of tumor response, we examined the correlation between the early MRI changes after the 1st cycle of neoadjuvant chemotherapy and later pathologic response after the 3rd cycle of neoadjuvant chemotherapy.Patients and method: 31 breast cancer patients who underwent neoadjuvant chemotherapy prior to surgery were analyzed. The baseline MRI was taken before neoadjuvant chemotherapy. Anthracycline plus taxane were administered to all patients. Post-chemotherapy MRI assessment was done just before the 2nd cycle of neoadjuvant chemotherapy. If the primary tumor was reduced more than 20% in the product of the longest and perpendicular diameter, those cases were classified as responders. Surgery was performed after the 3rd cycle of neoadjuvant chemotherapy. The pathologic response was assessed by measuring pathologic tumor size of viable tumor cells. Sensitivity, specificity, positive predictive value, and negative predictive value of MRI findings were calculated on the basis of histopathological examination.Results: Total 31 patients were examined. Of these patients, 2 patients had bilateral breast cancer. Therefore, a total of 33 lesions were evaluated. The median tumor size on baseline MRI was 4.5cm (range:2.1-10.0cm). 27 cases were classified as responders on early MRI findings. Of these cases, pathologic response was confirmed in 26 cases after surgery. Six cases were classified as non-responder on MRI. In this group, 3 cases showed pathologic response and 3 cases did not. Sensitivity, specificity, positive predictive value and negative predictive value of early MRI findings for the prediction of pathologic response were 89.7%, 75.0%, 96.3% and 50.0%, respectively.Conclusion: Post-chemotherapy MRI after the 1st cycle of neoadjuvant chemotherapy could differentiate responders from non-responders with high accuracy. It would be helpful to determine whether the chemotherapy regimen should be continued or not in the early phase of neoadjuvant therapy.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6057.
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Affiliation(s)
- H. Kim
- 1Korea Institute of Radiological & Medical Science, Korea Cancer Center Hospital, Republic of Korea
| | - E. Ko
- 2Korea Institute of Radiological & Medical Science, Korea Cancer Center Hospital, Republic of Korea
| | - E. Kim
- 1Korea Institute of Radiological & Medical Science, Korea Cancer Center Hospital, Republic of Korea
| | - E. Jo
- 1Korea Institute of Radiological & Medical Science, Korea Cancer Center Hospital, Republic of Korea
| | - M. Kim
- 3Korea Institute of Radiological & Medical Science, Korea Cancer Center Hospital, Republic of Korea
| | - W. Noh
- 1Korea Institute of Radiological & Medical Science, Korea Cancer Center Hospital, Republic of Korea
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Han S, Kwak K, Kim. J, Noh W, Lee M, Parks K. P63 Feasibility of concurrent adjuvant chemotherapy andradiotherapy after breast-conserving surgery in early breast cancer. Breast 2005. [DOI: 10.1016/s0960-9776(05)80101-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Noh W, Paik N, Moon N, Kim M, Han S. P57 Ipsilateral breast tumor recurrence afterbreast-conserving therapy: A comparison of quadrantectomy versus lumpectomy in a single institution. Breast 2005. [DOI: 10.1016/s0960-9776(05)80096-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Yu SH, Noh WC, Bang HY, Hwang DY, Choi DW, Lee JI, Paik NS, Moon NM, Jung JH. Sarcoma and Sarcomatous Metaplastic Carcinoma of the Breast. Cancer Res Treat 2001; 33:463-8. [PMID: 26680823 DOI: 10.4143/crt.2001.33.6.463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Primary sarcoma and SMC (sarcomatous metaplastic carcinoma) of the breast are very rare tumors, accounting for less than 1% of all breast malignancies. There are many controversies concerning the biological characteristics, prognosis and optimal treatment of these tumors owing to the rarity of incidence. The aims of this study were to elucidate the clinicopathologic characteristics of these tumors and to assist in elucidating the optimal treatment plan for the disease. MATERIALS AND METHODS 13 cases of primary sarcoma and 10 cases of SMC that had been treated at KCCH between 1984 and 2001 were retrospectively reviewed. Phyllodes tumors were excluded from our study. RESULTS Among the 13 cases of primary sarcoma included, stromal sarcoma occurred in 5 cases, osteosarcoma in 3 cases, angiosarcoma in 3 cases and spindle cell sarcoma in 2 cases. The mean age of the patients with primary sarcoma and SMC was 39.7 years and 55.1 years respectively (p=0.002). When survival rates were compared according to histologic types, size of tumor, histologic grade, type of surgery and use of adjuvant therapy, both size of tumor (p=0.0256) and histologic grade (p=0.0197) were shown to be prognostic factors. CONCLUSION There were no significantly different features between primary sarcoma and SMC in terms of biologic characteristics or survival rates, with the exception that patients with SMC were older than those with primary sarcoma. Histologic grade and size of tumor were significant prognostic factors of these tumors.
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