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ErbB2 status and the benefit from two or five years of adjuvant tamoxifen in postmenopausal early stage breast cancer

Stål, O ; Borg, A ; Fernö, M LU ; Källström, A C ; Malmström, P LU and Nordenskjöld, B (2000) In Annals of oncology : official journal of the European Society for Medical Oncology 11(12). p.1545-1550
Abstract

AIM: We aimed to study the importance of erbB2 status in early stage postmenopausal breast cancer for patients who participated in a trial of five vs. two years of adjuvant tamoxifen.

PATIENTS AND METHODS: We analysed the erbB2 status of the tumours from 577 patients participating in the trial, either by a DNA amplification assay (n = 181) or by measurement of the protein level with flow cytometry (n = 396).

RESULTS: ErbB2 was overexpressed or gene amplified in 102 of the patients (18%). Overall, erbB2-positive patients had a significantly lower recurrence-free probability than others, 62% at five years as compared to 83%, and showed a significantly decreased breast cancer survival rate (P = 0.0007). ErbB2 status was... (More)

AIM: We aimed to study the importance of erbB2 status in early stage postmenopausal breast cancer for patients who participated in a trial of five vs. two years of adjuvant tamoxifen.

PATIENTS AND METHODS: We analysed the erbB2 status of the tumours from 577 patients participating in the trial, either by a DNA amplification assay (n = 181) or by measurement of the protein level with flow cytometry (n = 396).

RESULTS: ErbB2 was overexpressed or gene amplified in 102 of the patients (18%). Overall, erbB2-positive patients had a significantly lower recurrence-free probability than others, 62% at five years as compared to 83%, and showed a significantly decreased breast cancer survival rate (P = 0.0007). ErbB2 status was significantly associated with recurrence and death in Cox multivariate analysis, adjusting for nodal status, tumour size and estrogen receptor status. The relative risk of recurrence (RR) for five vs. two years of tamoxifen was analysed in relation to erbB2 status for patients still disease-free two years after surgery. Whereas erbB2-negative patients showed significant benefit from prolonged treatment (RR = 0.62, 95% confidence interval (95% CI): 0.42-0.93), no benefit was evident for erbB2-positive patients (RR = 1.1, 95% CI: 0.41-3.2). When the same analysis was restricted to ER-positive patients a similar difference in relative hazard was obtained but the difference was not strictly significant (P = 0.065).

CONCLUSIONS: For early stage breast cancer patients treated with adjuvant tamoxifen, overexpression of erbB2 is an independent marker of poor prognosis. The results suggest that overexpression decreases the benefit from prolonged tamoxifen treatment.

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author
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author collaboration
publishing date
type
Contribution to journal
publication status
published
keywords
Aged, Antineoplastic Agents, Hormonal/administration & dosage, Breast Neoplasms/drug therapy, Chemotherapy, Adjuvant, DNA, Neoplasm/analysis, Drug Administration Schedule, Female, Flow Cytometry, Gene Expression Regulation, Neoplastic, Genes, erbB-2/genetics, Genetic Markers, Humans, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Postmenopause, Predictive Value of Tests, Prognosis, Risk Assessment, Tamoxifen/administration & dosage
in
Annals of oncology : official journal of the European Society for Medical Oncology
volume
11
issue
12
pages
1545 - 1550
publisher
Oxford University Press
external identifiers
  • pmid:11205461
  • scopus:0034487507
ISSN
0923-7534
DOI
10.1023/a:1008313310474
language
English
LU publication?
no
id
a5ec2fe0-a7ee-491e-bc54-9befa08caa45
date added to LUP
2022-03-02 13:17:51
date last changed
2024-02-19 17:29:50
@article{a5ec2fe0-a7ee-491e-bc54-9befa08caa45,
  abstract     = {{<p>AIM: We aimed to study the importance of erbB2 status in early stage postmenopausal breast cancer for patients who participated in a trial of five vs. two years of adjuvant tamoxifen.</p><p>PATIENTS AND METHODS: We analysed the erbB2 status of the tumours from 577 patients participating in the trial, either by a DNA amplification assay (n = 181) or by measurement of the protein level with flow cytometry (n = 396).</p><p>RESULTS: ErbB2 was overexpressed or gene amplified in 102 of the patients (18%). Overall, erbB2-positive patients had a significantly lower recurrence-free probability than others, 62% at five years as compared to 83%, and showed a significantly decreased breast cancer survival rate (P = 0.0007). ErbB2 status was significantly associated with recurrence and death in Cox multivariate analysis, adjusting for nodal status, tumour size and estrogen receptor status. The relative risk of recurrence (RR) for five vs. two years of tamoxifen was analysed in relation to erbB2 status for patients still disease-free two years after surgery. Whereas erbB2-negative patients showed significant benefit from prolonged treatment (RR = 0.62, 95% confidence interval (95% CI): 0.42-0.93), no benefit was evident for erbB2-positive patients (RR = 1.1, 95% CI: 0.41-3.2). When the same analysis was restricted to ER-positive patients a similar difference in relative hazard was obtained but the difference was not strictly significant (P = 0.065).</p><p>CONCLUSIONS: For early stage breast cancer patients treated with adjuvant tamoxifen, overexpression of erbB2 is an independent marker of poor prognosis. The results suggest that overexpression decreases the benefit from prolonged tamoxifen treatment.</p>}},
  author       = {{Stål, O and Borg, A and Fernö, M and Källström, A C and Malmström, P and Nordenskjöld, B}},
  issn         = {{0923-7534}},
  keywords     = {{Aged; Antineoplastic Agents, Hormonal/administration & dosage; Breast Neoplasms/drug therapy; Chemotherapy, Adjuvant; DNA, Neoplasm/analysis; Drug Administration Schedule; Female; Flow Cytometry; Gene Expression Regulation, Neoplastic; Genes, erbB-2/genetics; Genetic Markers; Humans; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Postmenopause; Predictive Value of Tests; Prognosis; Risk Assessment; Tamoxifen/administration & dosage}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{1545--1550}},
  publisher    = {{Oxford University Press}},
  series       = {{Annals of oncology : official journal of the European Society for Medical Oncology}},
  title        = {{ErbB2 status and the benefit from two or five years of adjuvant tamoxifen in postmenopausal early stage breast cancer}},
  url          = {{http://dx.doi.org/10.1023/a:1008313310474}},
  doi          = {{10.1023/a:1008313310474}},
  volume       = {{11}},
  year         = {{2000}},
}