Adding ovarian function suppression to tamoxifen in young women with hormone-sensitive breast cancer who remain premenopausal or resume menstruation after chemotherapy: 8-year follow-up of the randomized ASTRRA trial.

Authors

null

Soo Yeon Baek

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Soo Yeon Baek , Woo Chul Noh , Sei-Hyun Ahn , Hyun-Ah Kim , Jai Min Ryu , Seung Il Kim , Eun-Gyeong Lee , Seock-Ah Im , Yongsik Jung , Min Ho Park , Kyong Hwa Park , Su Hwan Kwang , Joon Jeong , Eunhwa Park , Sung Yong Kim , Min Hyuk Lee , Lee Su Kim , Woosung Lim , Seonok Kim , Hee Jeong Kim

Organizations

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, Department of Surgery, Konkuk Universitiy Medical Center, Seoul, South Korea, Department of Surgery, University of Ulsan College of Medicine and ASAN Medical Center, Seoul, South Korea, Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea, Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, Division of Breast Surgery, Department of Surgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea, Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, South Korea, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea, Department of Surgery, Ajou University, School of Medicine, Suwon, South Korea, Department of Surgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Gwangju, South Korea, Korea University Anam Hospital, Department of internal medicine, Division of Medical oncology/Hematology, Seoul, South Korea, Yeungnam University College of Medicine, Daegu, South Korea, Division of Breast Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea, Dong-A University Hospital, Dong-A University College of Medicine, Busan, South Korea, Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea, Soonchunhyang University Hospital, Seoul, South Korea, Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea, Ewha Womans University College of Medicine, Seoul, South Korea, Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, South Korea, Division of Breast, Department of Surgery, College of Medicine, University of Ulsan, Seoul, South Korea

Research Funding

Other Government Agency

Background: Addition of Ovarian Suppression to Tamoxifen in Young Women With Hormone-Sensitive Breast Cancer Who Remain Premenopausal or Regain Vaginal Bleeding After Chemotherapy (ASTRRA) trial, at 63 months median follow-up, showed that the addition of 2 years of ovarian function suppression (OFS) to Tamoxifen (TAM) significantly improved disease-free survival (DFS) compared with TAM alone in patients with hormone receptor–positive breast cancer who remain in a premenopausal state or resume ovarian function after chemotherapy. We report updated long-term outcomes from ASTRRA trial with 106.4 months median follow-up. Methods: This study is a post-trial follow-up of the ASTRRA trial, which randomly assigned 1,298 patients with breast cancer in a 1:1 ratio to receive TAM only (n = 647) or TAM + OFS (n = 635). The primary endpoint was DFS and secondary endpoint was overall survival (OS). We used Kaplan-Meier estimates for time to event endpoints and hazard ratios (HR) with 95% confidence interval (CI) from Cox-regression model. Results: At 106.4 months of median follow-up, there continues to be a statistically significant reduction in DFS event rate in favor of the TAM+OFS group. The estimated 8-year DFS rate was 85.4% in the TAM + OFS group and 80.2% in the TAM-only group (HR 0.67; 95% CI, 0.51 to 0.87). There were no significant differences in OS between two groups. The estimated 8-year OS rate was 96.5% in the TAM + OFS group and 95.3% in the TAM-only group (HR, 0.78; 95% CI, 0.49 to 1.25). The results of DFS and OS between the two groups defined from the time of random assignment to the time of events were also similar. Conclusions: These data demonstrate consistent survival advantages of adding OFS 2 years to TAM treatment over time, with the long-term follow-up reported to date. This study finding suggest that adding OFS to TAM should be considered for those who remain in a premenopausal state or resume ovarian function after chemotherapy. Longer follow-up is needed to fully evaluate the OS benefit.

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 Details

Meeting

2022 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Breast Cancer—Local/Regional/Adjuvant

Track

Breast Cancer

Sub Track

Adjuvant Therapy

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 506)

DOI

10.1200/JCO.2022.40.16_suppl.506

Abstract #

506

Abstract Disclosures