A phase III trial comparing adjuvant treatment with leuprorelin acetate 3M-Depot for 24 months with CMF chemotherapy in ER/PR + node + pre-perimenopausal breast cancer patients

Wallwiener, D.; Possinger, K.; Schmid, Peter; Tarutinov, V I; Suchina, L.; Hillger, H.; Kienle, E.; Maubach, L.; Kahlert, Steffen; Untch, Michael

doi:10.1200/jco.2004.22.14_suppl.533

Cited by 5 publications

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“…Several other randomized trials [8,14,15] compared CMF versus ovarian suppression with or without tamoxifen, and two compared FAC (5-fluorouracil, doxorubicin and cyclophosphamide) or FEC (5-fluorouracil, epirubicin and cyclophosphamide) versus ovarian suppression plus tamoxifen, all with similar results suggesting equivalence or superiority for the endocrine arm (Table 1). However, with the development of second- and third-generation combinations such as cyclophosphamide, epirubicin and 5-fluorouracil (CEF), which is more efficacious than standard Bonadonna CMF [16], and doxorubicin and cyclophosphamide (AC) taxol, which produces better results than AC alone [17], it is unclear what final conclusions one should draw from studies that compare 'first-generation' chemotherapy regimens such as AC or CMF versus OA by whatever means [18].…”

Section: Premenopausal Adjuvant Endocrine Therapymentioning

confidence: 97%

Endocrinology and hormone therapy in breast cancer: Endocrine therapy in premenopausal women

Pritchard

2005

Breast Cancer Res

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70AC = doxorubicin and cyclophosphamide; CAF = cyclophosphamide, doxorubicin and 5-fluorouracil; CEF = cyclophosphamide, epirubicin and 5-fluorouracil; CMF = cyclophosphamide, methotrexate and 5-fluorouracil; DFS = disease-free survival; EBCTCG = Early Breast Cancer Trialists Collaborative Group; ER = oestrogen receptor; FAC = 5-fluorouracil, doxorubicin and cyclophosphamide; FEC = 5-fluorouracil, epirubicin and cyclophosphamide; LHRH = luteinizing hormone-releasing hormone; OA = ovarian ablation; OS = overall survival; PgR = progesterone receptor; RR = relative risk; SE = standard error. Breast Cancer Research Vol 7 No 2 Pritchard AbstractEndocrine therapy remains important in premenopausal women with hormone receptor positive breast cancer. Ovarian ablation, used alone, is effective in delaying recurrence and increasing survival in such women. When added to chemotherapy, it is less clear that it is effective perhaps because of the endocrine ablative effect of chemotherapy. Trials comparing ovarian ablation with or without tamoxifen to CMF-type chemotherapy suggest that the endocrine therapy is equivalent to or better than this chemotherapy in women whose tumors have estrogen and/or progesterone receptor. Tamoxifen is also effective in preventing recurrence and prolonging survival in the adjuvant setting in premenopausal women. While most of the available data deals with tamoxifen given alone, it appears to have a similar beneficial effect when added to chemotherapy in the premenopausal adjuvant setting. Adjuvant aromatase inhibitors should not be used in premenopausal women. IntroductionEndocrine therapy, developed over a century ago [1,2], remains the most effective and the most clearly targeted form of systemic therapy for breast cancer. Endocrine treatments work best in women whose tumours are positive for oestrogen receptor (ER) and/or progesterone receptor (PgR). As we continue to search for newer targeted therapies that will shrink cancers effectively with few undesired side effects, and carry out complex statistical analyses to identify predictive factors, we should not forget the first targeted cancer therapy, namely ovarian ablation (OA) for breast cancer, and the first predictive factor for treatment of any cancer, the ER. Premenopausal adjuvant endocrine therapy Ovarian ablationFor many years adjuvant OA was used and felt to be helpful, but randomized trials were not done.Subsequently, a few small randomized trials were conducted in the 1960s and 1970s. Before the first Early Breast Cancer Trialists Collaborative Group (EBCTCG) or Oxford overview was published in 1984 [3], it was generally believed that these trials showed no benefit for OA. When the meta-analytic techniques used in the EBCTCG overview were applied to these small trials, however, it became apparent that OA was associated with a reasonably large positive effect on both disease-free survival (DFS) and overall survival (OS) in node-positive and node-negative premenopausal women [3][4][5].The most recent EBCTCG overview (www.ctsu.ox.ac....

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Section: Premenopausal Adjuvant Endocrine Therapymentioning

confidence: 97%

Endocrinology and hormone therapy in breast cancer: Endocrine therapy in premenopausal women

Pritchard

2005

Breast Cancer Res

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Current controversies in the management of early breast cancer

Estévez

Martín²,

Alba

et al. 2007

Clin Transl Oncol

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Medical professionals in general, and medical oncologists in particular, have highly stressful practices because they are under constant pressure to have the highest-quality, up-to-date evidence available in order to make the right decision for each individual patient. From a practical point of view, being updated on oncological and other medical specialties may seem an insurmountable task because the number of scientific publications has increased dramatically. The use of systematic reviews of randomised controlled trials or the application of results obtained from high-quality randomised controlled trials are some of the most common ways to address this need. Unfortunately, they do not cover all complex clinical situations that the majority of medical oncologists face in their outpatient consultations. In this review, we report the conclusions achieved in a multiexpert meeting where five important controversies in the treatment of breast cancer were analysed. Five highly experienced medical oncologists were required to defend an affirmative answer and another five were required to defend a negative answer for each of the clinical questions. After that, a one-day meeting was organised to debate each clinical question and to reach a consensus. We report here the content of this multi-expert meeting along with the conclusions drawn.

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Special issues related to the adjuvant therapy in very young women

Aebi

2005

The Breast

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A phase III trial comparing adjuvant treatment with leuprorelin acetate 3M-Depot for 24 months with CMF chemotherapy in ER/PR + node + pre-perimenopausal breast cancer patients

Cited by 5 publications

References 0 publications

Endocrinology and hormone therapy in breast cancer: Endocrine therapy in premenopausal women

Endocrinology and hormone therapy in breast cancer: Endocrine therapy in premenopausal women

Current controversies in the management of early breast cancer

Special issues related to the adjuvant therapy in very young women

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