The Impact of Progesterone Receptor Expression on Prognosis of Patients with Rapidly Proliferating, Hormone Receptor-positive Early Breast Cancer: a Analysis of the IBIS 3 Trial

Overview

Journal Ther Adv Med Oncol

Specialty Oncology

Date 2020 Mar 12

PMID 32158505

Citations 4

Authors

Sara Bravaccini

Giuseppe Bronte

Emanuela Scarpi

Sara Ravaioli

Roberta Maltoni

Anita Mangia

Maria Maddalena Tumedei

Maurizio Puccetti

Patrizia Serra

Lorenzo Gianni

Laura Amaducci

Nicoletta Biglia

Valentina Bounous

Angelo Virgilio Paradiso

Rosella Silvestrini

Dino Amadori

Andrea Rocca

Affiliations

Soon will be listed here.

Abstract

Background: In the Italian Breast Cancer Intergroup Studies (IBIS) 3 phase III trial, we compared cyclophosphamide, methotrexate, 5-fluorouracil (CMF) alone to sequential epirubicin/CMF regimens in patients with rapidly proliferating early breast cancer (RPEBC). We performed a analysis in the subgroup of patients with hormone-receptor-positive RPEBC on the prognostic role of progesterone receptor (PgR) status.

Methods: RPEBC was defined by thymidine labeling index (TLI) >3% or grade 3 or S-phase >10% or Ki67 >20%. We analyzed 466 patients with hormone-receptor-positive RPEBC receiving sequential epirubicin/CMF regimens followed by tamoxifen, and for whom the status of ER and PgR was available.

Results: Considering both cut-off values of 10% and 20%, PgR expression was significantly associated with age, menopausal status, and ER expression; HER2 status was associated with PgR status only at a cutoff value of 20% PgR. Upon univariate analysis, tumor size, nodal status, and PgR were significantly associated with disease-free survival (DFS) and overall survival (OS), while age class and local treatment type were associated only with DFS. Patients with PgR <20% showed lower 5- and 10-year DFS [hazard ratio (HR) = 1.48; 95%CI: 1.01-2.18; = 0.044] and OS (HR = 1.85; 95%CI: 1.08-3.19, = 0.025) rates compared with patients with PgR ⩾20%. Upon multivariate analysis, only tumor size, nodal status, and PgR were independent prognostic factors.

Conclusions: Our results highlight the independent prognostic relevance of PgR expression in patients with hormone-receptor-positive RPEBC treated with adjuvant chemotherapy and endocrine therapy, where the definition of prognostic subgroups is still a major need.

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