Neo-Adjuvant chemotherapy in breast cancer Study of 477 evaluable patients with primary breast cancers treated between 1980 and 1992

Purpose The value of adjuvant tamoxifen after chemotherapy for premenopausal women with breast cancer has not been adequately assessed. Patients and Methods Between 1993 and 1999, International Breast Cancer Study Group Trial 13-93 enrolled 1,246 assessable premenopausal women with axillary node-positive, operable breast cancer. All patients received chemotherapy (cyclophosphamide plus either doxorubicin or epirubicin for four courses followed by immediate or delayed classical cyclophosphamide, methotrexate, and fluorouracil for three courses), which was followed by either tamoxifen (20 mg daily) for 5 years or no further treatment. The primary end point was disease-free survival (DFS). Tumors were classified as estrogen receptor (ER) -positive (n = 735, 59%) if immunohistochemical (IHC) or ligand-binding assays (LBA) were clearly positive. The ER-negative group included all other tumors (n = 511, 41%). A subset of the ER-negative group was defined as ER absent (n = 108, 9%) if IHC staining was none or if the LBA result was 0 fmol/mg cytosol protein. The median follow-up time was 7 years. Results Tamoxifen improved DFS in the ER-positive cohort (hazard ratio [HR] for tamoxifen v no tamoxifen = 0.59; 95% CI, 0.46 to 0.75; P < .0001) but not in the ER-negative cohort (HR = 1.02; 95% CI, 0.77 to 1.35; P = .89). Tamoxifen had a detrimental effect on patients with ER-absent tumors compared with no tamoxifen in an unplanned exploratory analysis (HR = 2.10; 95% CI, 1.03 to 4.29; P = .04). Patients with ER-positive tumors who achieved chemotherapy-induced amenorrhea had a significantly improved outcome (HR for amenorrhea v no amenorrhea = 0.61; 95% CI, 0.44 to 0.86; P = .004), whether or not they received tamoxifen. Conclusion Tamoxifen after adjuvant chemotherapy significantly improved treatment outcome in premenopausal patients with endocrine-responsive disease, but its use as adjuvant therapy for patients with ER-negative tumors is not recommended.

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Is adjuvant chemotherapy of benefit for postmenopausal women who receive endocrine treatment for highly endocrine-responsive, node-positive breast cancer? International Breast Cancer Study Group Trials VII and 12–93

Breast Cancer Research and Treatment ◽

10.1007/s10549-008-0225-9 ◽

2008 ◽

Vol 116 (3) ◽

pp. 491-500 ◽

Cited By ~ 26

Author(s):

Olivia Pagani ◽

◽

Shari Gelber ◽

Edda Simoncini ◽

Monica Castiglione-Gertsch ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Postmenopausal Women ◽

Endocrine Treatment ◽

Study Group ◽

Cancer Study ◽

Node Positive ◽

Cancer Study Group ◽

Breast Cancer Study ◽

Positive Breast Cancer

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PP-5-16 A Study of Postoperative Adjuvant Chemotherapy of 5′-DFUR in Breast Cancer Patients (1st Report) — On Compliance and Safety — “The 5′-BC Study Group” (5′-DFUR Adjuvant Chemotherapy for Breast Cancer Study Group)

European Journal of Cancer ◽

10.1016/0959-8049(96)84182-7 ◽

1996 ◽

Vol 32 ◽

pp. 37

Author(s):

H. Koyama ◽

O. Abe ◽

J. Uchino ◽

W. Hayasaka ◽

R. Abe ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Study Group ◽

Breast Cancer Patients ◽

Postoperative Adjuvant Chemotherapy ◽

Cancer Study ◽

Cancer Study Group ◽

Breast Cancer Study ◽

Group 5

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Lift the Veil of Breast Cancers Using Four or Fewer Critical Genes

10.1101/2021.10.19.465026 ◽

2021 ◽

Author(s):

Zhengjun Zhang

Keyword(s):

Breast Cancer ◽

Differentially Expressed Gene ◽

Gene Interaction ◽

Differentially Expressed ◽

Biological Knowledge ◽

Interaction Patterns ◽

Breast Cancers ◽

Luminal A ◽

Cancer Study ◽

Breast Cancer Study

Tackling breast cancer problems is like mastering a puzzle, and the mystery is not yet solved. Reported key genes in the literature could not be confirmed whether they are vital to breast cancer formations due to lack of convincing accuracy, although they may be biologically directly related to breast cancer based on present biological knowledge. It is hoped vital genes can be identified with the highest possible accuracy, e.g., 100% accuracy and convincing causal patterns beyond what has been known in breast cancer. One hope is that finding gene-gene interaction signatures and functional effects may solve the puzzle. This research uses a recently developed competing linear factor analysis method in differentially expressed gene detection to advance the study of breast cancer formation to its deepest root level as deep as possible. Surprisingly, three genes are detected to be differentially expressed in TNBC, and non-TNBC (Her2, Luminal A, Luminal B) samples with 100% sensitivity and 100% specificity in one study of triple-negative breast cancers (TNBC, with 54675 genes and 265 samples). These three genes show a clear signature pattern of how TNBC patients can be grouped. For another TNBC study (with 54673 genes and 66 samples), four genes bring the same accuracy of 100% sensitivity and 100% specificity. Four genes are found to have the same accuracy of 100% sensitivity and 100% specificity in one breast cancer study (with 54675 genes and 121 samples), and the same four genes bring an accuracy of 100% sensitivity and 96.5% specificity in the fourth breast cancer study (with 60483 genes and 1217 samples.) These results show the four-gene-based classifiers are robust and accurate. The detected genes naturally classify patients into subtypes, e.g., seven subtypes. These findings demonstrate the clearest gene-gene interaction patterns and functional effects with the smallest numbers of genes and the highest accuracy compared with findings reported in the literature. The four genes are considered to be essential for breast cancer studies and practice. They can provide focused, targeted researches and precision medicine for each subtype of breast cancer. New breast cancer disease types may be detected using the classified subtypes, and hence new effective therapies can be developed.

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