Adjuvant endocrine therapy choices in premenopausal patients with hormone receptor-positive early breast cancer: Insights from the prospective GIM23-POSTER study

Breast. 2024 Oct:77:103769. doi: 10.1016/j.breast.2024.103769. Epub 2024 Jul 9.

Abstract

Background: Most premenopausal patients with early breast cancer (eBC) are diagnosed with hormone receptor-positive disease and therefore candidate for adjuvant endocrine therapy (ET).

Patients and methods: The Gruppo Italiano Mammella (GIM) 23-POSTER (GIM23) is a multicenter, prospective, observational study conducted in 26 Italian institutions, aiming to evaluate ET choices for premenopausal patients affected by hormone receptor-positive eBC in a real-world setting. Here we report also the results in terms of type of ET prescribed according to the definition of high-risk patients by monarchE and NATALEE trials.

Results: Between October 2019 and June 2022, 600 premenopausal patients were included, with a median age of 46 years. Almost half (271, 45.2 %) of the patients had stage I disease, while 254 (42.3 %) and 60 (10.0 %) patients had stage II and III, respectively. Overall, 149 (25.1 %) patients received tamoxifen alone, 83 (14.0 %) tamoxifen with ovarian function suppression (OFS), while 361 (60.9 %) received aromatase inhibitor (AI) with OFS. Patients treated with AI and OFS had higher number of metastatic axillary nodes, higher grade and more often received chemotherapy (all p < 0.001). According to the inclusion criteria of the monarchE and NATALEE trials, 81 patients (15.6 %) were considered high-risk for the monarchE and received AI with OFS in 88.9 % of the cases, while 231 patients (44.4 %) were considered high-risk for the NATALEE trial and received AI with OFS in 74.5 % of cases.

Conclusions: AI with OFS is the most prescribed adjuvant ET among premenopausal patients, especially in the presence of high-risk features.

Keywords: Adjuvant endocrine therapy; Aromatase inhibitors; Breast cancer; CDK4/6-Inhibitors; Ovarian function suppression; Premenopausal patients; Tamoxifen.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Adult
  • Antineoplastic Agents, Hormonal* / therapeutic use
  • Aromatase Inhibitors* / therapeutic use
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / metabolism
  • Breast Neoplasms* / pathology
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Italy
  • Middle Aged
  • Neoplasm Staging
  • Premenopause*
  • Prospective Studies
  • Receptors, Estrogen / analysis
  • Receptors, Estrogen / metabolism
  • Tamoxifen* / therapeutic use

Substances

  • Tamoxifen
  • Antineoplastic Agents, Hormonal
  • Aromatase Inhibitors
  • Receptors, Estrogen