Publication

Late recurrences in early breast cancer: for whom and how long is endocrine therapy beneficial?

Journal Paper/Review - May 1, 2014

Units
PubMed
Doi

Citation
Knauer M, Filipits M, Dubsky P. Late recurrences in early breast cancer: for whom and how long is endocrine therapy beneficial?. Breast Care (Basel) 2014; 9:97-100.
Type
Journal Paper/Review (English)
Journal
Breast Care (Basel) 2014; 9
Publication Date
May 1, 2014
Issn Print
1661-3791
Pages
97-100
Brief description/objective

During the last decade, besides the well-established clinical-pathological predictors for the risk of late recurrence in breast cancer, such as estrogen receptor status, and T and N stage, a variety of multigene assays have been shown to improve prognostication and prediction in this setting. Several clinical trials have evaluated the role of extended endocrine therapy with tamoxifen (ATLAS) or aromatase inhibitors (MA.17, NSABP-B33 and ABCSG 6a), and other randomized studies are still ongoing. However, among this patient population, it is still not clear who could benefit from extended therapy and what the optimal treatment duration should be. New multigene assays such as EndoPredict, PAM50 ROR-score, HOXB13/IL17BR ratio and Breast Cancer Index provide significant and relevant prognostic information concerning the likelihood of recurrence beyond 5 years after surgery. The identified low-risk subgroups not only show a very favorable prognosis, they also seem to have only little benefit from extended aromatase inhibitor therapy. Many of these reverse transcriptase/polymerase chain reaction-based techniques have been validated in archived tumor material from large phase III trials, and will soon be available to routine pathology laboratories as an aid in clinical decision-making for patients.