|The following article features coverage from the 2020 San Antonio Breast Cancer Symposium. Click here to read more of Cancer Therapy Advisor‘s conference coverage.|
Certain patients with luminal early breast cancer and up to 3 involved lymph nodes can be treated with adjuvant endocrine therapy alone, according to the primary outcome analysis of the ADAPT HR+/HER2- trial (ClinicalTrials.gov Identifier: NCT01779206), presented at the 2020 Virtual San Antonio Breast Cancer Symposium (SABCS).
The analysis included patients with luminal early breast cancer who were candidates for adjuvant chemotherapy. All patients received preoperative standard endocrine therapy followed by adjuvant endocrine therapy alone. Patients were grouped by recurrence score and Ki67 expression level, and outcomes were evaluated.
One group of patients had up to 3 involved lymph nodes and recurrence score of 0 to 11. The other group of patients had a recurrence score of 12 to 25 and responded to preoperative endocrine therapy, which was determined by having Ki67 expression level of 10% or lower.
The 5-year invasive disease-free survival rate for patients with recurrence scores of 0 to 11 was noninferior to that of patients with recurrence scores of 12 to 25 who responded to preoperative endocrine therapy (93.9% vs 92.6%, respectively), as was the 5-year distant disease-free survival (dDFS) rate (96.3% vs 95.6%, respectively) and 5-year overall survival rate (98.0% vs 97.3%, respectively).
The 5-year dDFS among patient groups did not differ by age or by nodal subgroups, with the exception of 1 subgroup.
Among patients with recurrence scores of 12 to 25 who responded to preoperative endocrine therapy, those with 3 involved lymph nodes had a low 5-year dDFS of 75.9%.
“These patients may not be good candidates for endocrine therapy alone,” said study presenter Nadia Harbeck, MD, PhD, University of Munich (LMU), Germany.
She concluded that, irrespective of age, the following patients can be treated by endocrine therapy alone: patients with 0 to 3 involved lymph nodes and recurrence score of 0 to 11; and patients with limited nodal burden, recurrence score of 12 to 25, and endocrine response after short preoperative endocrine therapy.
Disclosures: Dr Harbeck disclosed financial relationships with several pharmaceutical companies. For a full list of disclosures, please refer to the presentation abstract.
Read more of Cancer Therapy Advisor‘s coverage of the 2020 SABCS meeting by visiting the conference page.
Harbeck N, Gluz O, Kuemmel S, et al. Endocrine therapy alone in patients with intermediate or high-risk luminal early breast cancer (0-3 lymph nodes), Recurrence Score <26 and Ki67 response after preoperative endocrine therapy: First efficacy results from the ADAPT HR+/HER2- trial (n=4,690). Presented at: 2020 Virtual San Antonio Breast Cancer Symposium; December 8-11, 2020. Abstract GS4-04.