KMID : 1134120210240020164
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Journal of Breast Cancer 2021 Volume.24 No. 2 p.164 ~ p.174
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Clinical Outcomes Following Letrozole Treatment according to Estrogen Receptor Expression in Postmenopausal Women: LETTER Study (KBCSG-006)
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Ahn Sung-Gwe
Nam Seok-Jin Ahn Sei-Hyun Jung Yong-Sik Park Heung-Kyu Lee Soo-Jung Kang Sung-Soo Han Won-Shik Park Kyong-Hwa Park Yong-Lai Lee Ji-Hyoun Youn Hyun-Jo Kim Jun-Hyun Yoo Young-Bum Song Jeong-Yoon Ko Byung-Kyun Gwak Geum-Hee Chung Min-Sung Kim Sung-Yong Cho Seo-Heon Kim Do-Yil Chang Myung-Chul Moon Byung-In Kim Lee-Su Kim Sei-Joong Park Min-Ho Kim Tae-Hyun Cho Ji-Hyoung Lim Cheol-Wan Bae Young-Tae Gong Gyung-Yub Bae Young-Kyung Lee Ah-Won Jeong Joon
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Abstract
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Purpose: In this trial, we investigated the efficacy and safety of adjuvant letrozole for hormone receptor (HR)-positive breast cancer. Here, we report the clinical outcome in postmenopausal women with HR-positive breast cancer treated with adjuvant letrozole according to estrogen receptor (ER) expression levels.
Methods: In this multi-institutional, open-label, observational study, postmenopausal patients with HR-positive breast cancer received adjuvant letrozole (2.5 mg/daily) for 5 years unless they experienced disease progression or unacceptable toxicity or withdrew their consent. The patients were stratified into the following 3 groups according to ER expression levels using a modified Allred score (AS): low, intermediate, and high (AS 3?4, 5?6, and 7?8, respectively). ER expression was centrally reviewed. The primary objective was the 5-year disease-free survival (DFS) rate.
Results: Between April 25, 2010, and February 5, 2014, 440 patients were enrolled. With a median follow-up of 62.0 months, the 5-year DFS rate in all patients was 94.2% (95% confidence interval [CI], 91.8?96.6). The 5-year DFS and recurrence-free survival (RFS) rates did not differ according to ER expression; the 5-year DFS rates were 94.3% and 94.1%in the low-to-intermediate and high expression groups, respectively (p = 0.6), and the corresponding 5-year RFS rates were 95.7% and 95.4%, respectively (p = 0.7). Furthermore, 25 patients discontinued letrozole because of drug toxicity.
Conclusion: Treatment with adjuvant letrozole showed very favorable treatment outcomes and good tolerability among Korean postmenopausal women with ER-positive breast cancer, independent of ER expression.
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KEYWORD
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Breast neoplasms, Letrozole, Postmenopause, Receptors, estrogen
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