Effect of prior chemotherapy regimens on the efficacy of endocrine therapy within a German cohort of the TEAM trial

• Published in: Journal of cancer research and clinical oncology Vol. 140; no. 1; pp. 117 - 126
• Main Authors: Bossart, Michaela, Hadji, Peyman, Klar, Maximilian, Kieback, Dirk G., Hasenburg, Annette
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 2014; Springer Nature B.V
• Subjects: Androstadienes - administration & dosage; Androstadienes - therapeutic use; Antineoplastic Agents, Hormonal - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Aromatase Inhibitors - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Cancer Research; Chemotherapy; Chemotherapy, Adjuvant; Clinical outcomes; Cohort Studies; Disease-Free Survival; Endocrine therapy; Female; Hematology; Humans; Internal Medicine; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Grading; Neoplasm Staging; Oncology; Original Paper; Postmenopause; Retrospective Studies; Survival Rate; Tamoxifen - administration & dosage; Germany; Endocrine therapy; Aromatase inhibitor; Early breast cancer; Exemestane
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-013-1551-9

Purpose Prior chemotherapy may affect the efficacy of endocrine therapy. Methods The tamoxifen exemestane adjuvant multinational (TEAM) trial compared 5 years of adjuvant exemestane with the sequence of tamoxifen followed by exemestane in postmenopausal women with hormone-receptor-positive breast cancer. A total of 1,502 patients were enrolled in Germany (739 received tamoxifen followed by exemestan and 610 exemestan alone). A retrospective analysis of the German cohort of TEAM was conducted to determine whether prior chemotherapy affected clinical outcome of endocrine therapy. Results Overall survival, disease-free survival and distant recurrence were similar between patients who received sequential therapy and those who received exemestane monotherapy, irrespective of prior chemotherapy. Overall survival was not significantly different between patients who had received prior chemotherapy and those who had not ( P  = 0.2836). Disease-free survival and distant recurrence were significantly better in patients who had not received prior chemotherapy versus those who had ( P  = 0.0308 and P  = 0.0001). In patients receiving sequential therapy, there were no significant differences in overall survival according to prior chemotherapy use ( P  = 0.1812). However, disease-free survival and distant recurrence were significantly different dependent on prior chemotherapy ( P  = 0.0143 and P  = 0.0053). Conclusion In conclusion, there was no difference in overall survival between breast cancer patients who did receive prior chemotherapy before endocrine therapy and those who had not. Patients who had not received prior chemotherapy had significantly improved disease-free survival and less distant recurrence versus those who had received chemotherapy.