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Adjuvant ovarian function suppression and aromatase inhibitors in premenopausal patients with hormone receptor and HER2 positive breast cancer, by timing of chemotherapy and trastuzumab and response to neoadjuvant therapy

2026-02Artigo científico Acesso aberto
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datacite.subject.sdg03:Saúde de Qualidade
datacite.subject.sdg05:Igualdade de Género
datacite.subject.sdg09:Indústria, Inovação e Infraestruturas
dc.contributor.authorShai, Ayelet
dc.contributor.authorWildiers, Hans
dc.contributor.authorVenieri, Claudio
dc.contributor.authorPogoda, Katarzyna
dc.contributor.authorLinderholm, Barbro
dc.contributor.authorLambertini, Matteo
dc.contributor.authorMatos, Leonor
dc.contributor.authorD'Esposito, Eleonora De Maio
dc.contributor.authorHajjaji, Nawale
dc.contributor.authorMatos, Erika
dc.contributor.authorCortijo, Lucía González
dc.contributor.authorFotia, Giuseppe
dc.contributor.authorFortuna, Ana
dc.contributor.authorSella, Tal
dc.contributor.authorGouveia, Helena
dc.contributor.authorRosset, Laurent
dc.contributor.authorConstantinidou, Anastasia
dc.contributor.authorAngeli, Eurydice
dc.contributor.authorCicin, Irfan
dc.contributor.authorTjan-Heijnen, Vivianne
dc.contributor.authorRuyssers, Natacha
dc.contributor.authorDemasure, Sofie
dc.contributor.authorRemilah, Areen Abu
dc.contributor.authorHuygh, Greet
dc.contributor.authorShimon, Shani Paluch
dc.contributor.authorChiappe, Edoardo
dc.contributor.authorShirron, Natali
dc.contributor.authorNeven, Patrick
dc.contributor.authorArtac, Mehmet
dc.contributor.authorKilictas, Bilgesah
dc.contributor.authorBaranseh, Jalal
dc.contributor.authorRubio, Elena Vicente
dc.contributor.authorAtci, Mustafa
dc.contributor.authorAmato, Ottavia
dc.contributor.authorvan Duijnhoven, Frederieke
dc.date.accessioned2026-05-07T09:53:00Z
dc.date.available2026-05-07T09:53:00Z
dc.date.issued2026-02
dc.description.abstractBackground: The benefit of adjuvant ovarian function suppression (OFS) and aromatase inhibitors (AI) in premenopausal patients with hormone receptor positive, HER2 positive (HR+/HER2+) breast cancer (BC) is unclear. We aimed to investigate this question in a retrospective cohort, stratified by timing (adjuvant or neoadjuvant) of chemotherapy and trastuzumab and by response to neoadjuvant therapy. Methods: Patients aged <45Y at diagnosis, with stage I-III HR + HER2+ BC, treated with (neo)adjuvant chemotherapy and trastuzumab ( +/- pertuzumab) and endocrine therapy were included. LHRH-agonists and oophorectomy were considered OFS. We compared distant disease-free survival (DDFS) with tamoxifen, OFS + tamoxifen and OFS + AI in three cohorts: neoadjuvant-pathologic complete response (pCR), neoadjuvantresidual disease (RD) and adjuvant. Endocrine therapy (ET) was modeled as a time dependent covariate in cox logistic regression analyses. Results: The study included 1124 patients with median follow-up of 72.6 months (range:0-205 months). DDFS rates at 5 years were 83.9 %, 86.8 % and 92.1 % with tamoxifen, OFS + tamoxifen and OFS + AI respectively in the RD group, 94.3 %, 97.6 % and 96.5 % in the pCR group, and 94.3 %, 93.4 % and 98.6 % in the adjuvant group. OFS + AI was associated with better DDFS compared to tamoxifen in the RD group (n = 366) (multi-variable weighted HR 0.28. 95 % CI 0.11-.069, p = 0.006), but associations of ET with DDFS in the pCR (n = 307, p = 0.59) and adjuvant (n = 451, p = 0.18) cohorts were not detected. Stage III was associated with worse DDFS in all groups. Conclusion: OFS + AI were associated with better DDFS in patients with RD after neoadjuvant therapy. Our findings can assist shared decision-making on adjuvant endocrine therapy of these patients.eng
dc.identifier.doi10.1016/j.breast.2025.104669
dc.identifier.issn0960-9776
dc.identifier.urihttp://hdl.handle.net/10400.1/28878
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation.hasversionhttps://www.thebreastonline.com/article/S0960-9776(25)00888-4/fulltext
dc.relation.ispartofThe Breast
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectAdjuvant endocrine therapy
dc.subjectAromatase inhibitors
dc.subjectHER2 positive
dc.subjectLHRH agonists
dc.subjectNeoadjuvant
dc.subjectOvarian function suppression
dc.subjectPathological complete response
dc.subjectResidual disease
dc.subjectTamoxifen
dc.titleAdjuvant ovarian function suppression and aromatase inhibitors in premenopausal patients with hormone receptor and HER2 positive breast cancer, by timing of chemotherapy and trastuzumab and response to neoadjuvant therapyeng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage9
oaire.citation.startPage104669
oaire.citation.titleThe Breast
oaire.citation.volume85
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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