Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
Sara Bravaccini , Giuseppe Bronte , Emanuela Scarpi , Sara Ravaioli , Maria Maddalena Tumedei , Roberta Maltoni , Maurizio Puccetti , Anita Mangia , Dino Amadori , Andrea Rocca
Background: The prognostic role of progesterone receptor (PgR) in highly proliferating early breast cancer (BC) is not well established. We retrospectively explored this biomarker in a cohort of patients with highly proliferating tumors enrolled in a phase III trial of adjuvant therapy. Methods: 1066 patients with N- or 1-3 N+ BC were randomized to receive: epirubicin followed by CMF, CMF followed by epirubicin, or CMF alone. Rapidly proliferating tumors were defined by thymidine labeling index (TLI) > 3% or histological grade 3 or S-phase > 10% or Ki67 > 20%. We analyze the subgroup of 466 patients with hormone receptor (HR)-positive tumors treated with sequential epirubicin/CMF regimens followed by tamoxifen and for whom immunohistochemical assessments of estrogen receptor (ER), PgR, HER2 and Ki67 were available. Disease-free (DFS) and overall survival (OS) curves were built with the Kaplan–Meier estimator and compared by logrank test and Cox regression models. Results: PgR expression was significantly associated with ER expression, HER2 status, age and menopausal status, but not with Ki67, tumor size and nodal status. PgR cutoff values of 10% and 20% were chosen based on a Receiver Operating Characteristics analysis and the literature data. DFS and OS figures at 5 and 10 years, as well as the relative hazard ratios, according to the different PgR cutoff values, are reported in the table. Conclusions: Our results confirm the prognostic relevance of PgR expression in a cohort of patients with highly proliferating, HR-positive early BC treated with adjuvant chemotherapy and endocrine therapy.
n. pts | % 5-year DFS (95% CI) | % 10-year DFS (95% CI) | HR (95% CI) | p | % 5-year OS (95% CI) | % 10-year OS (95% CI) | HR (95% CI) | p | |
---|---|---|---|---|---|---|---|---|---|
Overall | 466 | 85 | 70 | - | - | 94 | 85 | - | - |
(81-88) | (65-75) | (92-96) | (81-89) | ||||||
Cutoff 10% | |||||||||
PgR ≥10 | 338 | 89 | 73 | 1.00 | 96 | 88 | 1.00 | ||
(85-92) | (67-79) | (93-98) | (83-92) | ||||||
PgR < 10 | 128 | 78 | 64 | 1.48 | 0.045 | 89 | 79 | 1.84 | 0.023 |
(70-85) | (55-73) | (1.01-2.18) | (84-95) | (71-87) | (1.09-3.11) | ||||
Cutoff 20% | |||||||||
PgR ≥20 | 293 | 89 | 74 | 1.00 | 95 | 89 | 1.00 | ||
(85-93) | (67-80) | (92-98) | (84-93) | ||||||
PgR < 20 | 173 | 71 | 65 | 1.51 | 0.030 | 92 | 80 | 1.87 | 0.018 |
(74-87) | (56-73) | (1.04-2.19) | (88-96) | (73-87) | (1.11-3.16) |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2023 ASCO Annual Meeting
First Author: Tarek Mohamed Ahmed Abdel-Fatah
2023 ASCO Annual Meeting
First Author: Esther G Chong
2023 ASCO Annual Meeting
First Author: Stephanie L. Graff
2023 ASCO Annual Meeting
First Author: Stefania Gori