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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Which patients benefit most from adjuvant aromatase inhibitors? Results using a composite measure of prognostic risk in the BIG 1-98 randomized trial</title><author><name sortKey="Viale, G" sort="Viale, G" uniqKey="Viale G" first="G." last="Viale">G. Viale</name><affiliation><nlm:aff id="aff1">International Breast Cancer Study Group Central Pathology Office, Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Regan, M M" sort="Regan, M M" uniqKey="Regan M" first="M. M." last="Regan">M. M. Regan</name><affiliation><nlm:aff id="aff2">International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard School of Public Health, Frontier Science and Technology Research Foundation, Boston, USA</nlm:aff></affiliation></author><author><name sortKey="Dell Orto, P" sort="Dell Orto, P" uniqKey="Dell Orto P" first="P." last="Dell'Orto">P. Dell'Orto</name><affiliation><nlm:aff id="aff1">International Breast Cancer Study Group Central Pathology Office, Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Mastropasqua, M G" sort="Mastropasqua, M G" uniqKey="Mastropasqua M" first="M. G." last="Mastropasqua">M. G. Mastropasqua</name><affiliation><nlm:aff id="aff1">International Breast Cancer Study Group Central Pathology Office, Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Maiorano, E" sort="Maiorano, E" uniqKey="Maiorano E" first="E." last="Maiorano">E. Maiorano</name><affiliation><nlm:aff id="aff3">International Breast Cancer Study Group Central Pathology Office, Department of Pathological Anatomy, University of Bari ‘Aldo Moro’, Bari, Italy</nlm:aff></affiliation></author><author><name sortKey="Rasmussen, B B" sort="Rasmussen, B B" uniqKey="Rasmussen B" first="B. B." last="Rasmussen">B. B. Rasmussen</name><affiliation><nlm:aff id="aff4">Department of Pathology, Herlev Hospital, Herlev, Denmark</nlm:aff></affiliation></author><author><name sortKey="Macgrogan, G" sort="Macgrogan, G" uniqKey="Macgrogan G" first="G." last="Macgrogan">G. Macgrogan</name><affiliation><nlm:aff id="aff5">Department of Pathology, Institut Bergonié, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="Forbes, J F" sort="Forbes, J F" uniqKey="Forbes J" first="J. F." last="Forbes">J. F. Forbes</name><affiliation><nlm:aff id="aff6">Australian New Zealand Breast Cancer Trials Group, University of Newcastle, Calvary Mater Newcastle, Newcastle, Australia</nlm:aff></affiliation></author><author><name sortKey="Paridaens, R J" sort="Paridaens, R J" uniqKey="Paridaens R" first="R. J." last="Paridaens">R. J. Paridaens</name><affiliation><nlm:aff id="aff7">Department of Medical Oncology, University Hospital Gasthuisberg, Catholic University of Leuven, Leuven, Belgium</nlm:aff></affiliation></author><author><name sortKey="Colleoni, M" sort="Colleoni, M" uniqKey="Colleoni M" first="M." last="Colleoni">M. Colleoni</name><affiliation><nlm:aff id="aff8">Department of Medicine, European Institute of Oncology, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Lang, I" sort="Lang, I" uniqKey="Lang I" first="I." last="Láng">I. Láng</name><affiliation><nlm:aff id="aff9">National Institute of Oncology, Budapest, Hungary</nlm:aff></affiliation></author><author><name sortKey="Thurlimann, B" sort="Thurlimann, B" uniqKey="Thurlimann B" first="B." last="Thürlimann">B. Thürlimann</name><affiliation><nlm:aff id="aff10">Swiss Group for Clinical Cancer Research, Breast Center, Kantonsspital, St Gallen, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Mouridsen, H" sort="Mouridsen, H" uniqKey="Mouridsen H" first="H." last="Mouridsen">H. Mouridsen</name><affiliation><nlm:aff id="aff11">Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark</nlm:aff></affiliation></author><author><name sortKey="Mauriac, L" sort="Mauriac, L" uniqKey="Mauriac L" first="L." last="Mauriac">L. Mauriac</name><affiliation><nlm:aff id="aff12">Medical Oncology, Institut Bergonié, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="Gelber, R D" sort="Gelber, R D" uniqKey="Gelber R" first="R. D." last="Gelber">R. D. Gelber</name><affiliation><nlm:aff id="aff2">International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard School of Public Health, Frontier Science and Technology Research Foundation, Boston, USA</nlm:aff></affiliation></author><author><name sortKey="Price, K N" sort="Price, K N" uniqKey="Price K" first="K. N." last="Price">K. N. Price</name><affiliation><nlm:aff id="aff2">International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard School of Public Health, Frontier Science and Technology Research Foundation, Boston, USA</nlm:aff></affiliation></author><author><name sortKey="Goldhirsch, A" sort="Goldhirsch, A" uniqKey="Goldhirsch A" first="A." last="Goldhirsch">A. Goldhirsch</name><affiliation><nlm:aff id="aff8">Department of Medicine, European Institute of Oncology, Milan, Italy</nlm:aff></affiliation><affiliation><nlm:aff id="aff13">Oncology Institute of Southern Switzerland, Bellinzona, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Gusterson, B A" sort="Gusterson, B A" uniqKey="Gusterson B" first="B. A." last="Gusterson">B. A. Gusterson</name><affiliation><nlm:aff id="aff14">International Breast Cancer Study Group Central Pathology Review Office, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK</nlm:aff></affiliation></author><author><name sortKey="Coates, A S" sort="Coates, A S" uniqKey="Coates A" first="A. S." last="Coates">A. S. Coates</name><affiliation><nlm:aff id="aff15">School of Public Health, University of Sydney, Sydney, Australia</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21335417</idno><idno type="pmc">3179413</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179413</idno><idno type="RBID">PMC:3179413</idno><idno type="doi">10.1093/annonc/mdq738</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">001733</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001733</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Which patients benefit most from adjuvant aromatase inhibitors? Results using a composite measure of prognostic risk in the BIG 1-98 randomized trial</title><author><name sortKey="Viale, G" sort="Viale, G" uniqKey="Viale G" first="G." last="Viale">G. Viale</name><affiliation><nlm:aff id="aff1">International Breast Cancer Study Group Central Pathology Office, Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Regan, M M" sort="Regan, M M" uniqKey="Regan M" first="M. M." last="Regan">M. M. Regan</name><affiliation><nlm:aff id="aff2">International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard School of Public Health, Frontier Science and Technology Research Foundation, Boston, USA</nlm:aff></affiliation></author><author><name sortKey="Dell Orto, P" sort="Dell Orto, P" uniqKey="Dell Orto P" first="P." last="Dell'Orto">P. Dell'Orto</name><affiliation><nlm:aff id="aff1">International Breast Cancer Study Group Central Pathology Office, Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Mastropasqua, M G" sort="Mastropasqua, M G" uniqKey="Mastropasqua M" first="M. G." last="Mastropasqua">M. G. Mastropasqua</name><affiliation><nlm:aff id="aff1">International Breast Cancer Study Group Central Pathology Office, Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Maiorano, E" sort="Maiorano, E" uniqKey="Maiorano E" first="E." last="Maiorano">E. Maiorano</name><affiliation><nlm:aff id="aff3">International Breast Cancer Study Group Central Pathology Office, Department of Pathological Anatomy, University of Bari ‘Aldo Moro’, Bari, Italy</nlm:aff></affiliation></author><author><name sortKey="Rasmussen, B B" sort="Rasmussen, B B" uniqKey="Rasmussen B" first="B. B." last="Rasmussen">B. B. Rasmussen</name><affiliation><nlm:aff id="aff4">Department of Pathology, Herlev Hospital, Herlev, Denmark</nlm:aff></affiliation></author><author><name sortKey="Macgrogan, G" sort="Macgrogan, G" uniqKey="Macgrogan G" first="G." last="Macgrogan">G. Macgrogan</name><affiliation><nlm:aff id="aff5">Department of Pathology, Institut Bergonié, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="Forbes, J F" sort="Forbes, J F" uniqKey="Forbes J" first="J. F." last="Forbes">J. F. Forbes</name><affiliation><nlm:aff id="aff6">Australian New Zealand Breast Cancer Trials Group, University of Newcastle, Calvary Mater Newcastle, Newcastle, Australia</nlm:aff></affiliation></author><author><name sortKey="Paridaens, R J" sort="Paridaens, R J" uniqKey="Paridaens R" first="R. J." last="Paridaens">R. J. Paridaens</name><affiliation><nlm:aff id="aff7">Department of Medical Oncology, University Hospital Gasthuisberg, Catholic University of Leuven, Leuven, Belgium</nlm:aff></affiliation></author><author><name sortKey="Colleoni, M" sort="Colleoni, M" uniqKey="Colleoni M" first="M." last="Colleoni">M. Colleoni</name><affiliation><nlm:aff id="aff8">Department of Medicine, European Institute of Oncology, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Lang, I" sort="Lang, I" uniqKey="Lang I" first="I." last="Láng">I. Láng</name><affiliation><nlm:aff id="aff9">National Institute of Oncology, Budapest, Hungary</nlm:aff></affiliation></author><author><name sortKey="Thurlimann, B" sort="Thurlimann, B" uniqKey="Thurlimann B" first="B." last="Thürlimann">B. Thürlimann</name><affiliation><nlm:aff id="aff10">Swiss Group for Clinical Cancer Research, Breast Center, Kantonsspital, St Gallen, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Mouridsen, H" sort="Mouridsen, H" uniqKey="Mouridsen H" first="H." last="Mouridsen">H. Mouridsen</name><affiliation><nlm:aff id="aff11">Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark</nlm:aff></affiliation></author><author><name sortKey="Mauriac, L" sort="Mauriac, L" uniqKey="Mauriac L" first="L." last="Mauriac">L. Mauriac</name><affiliation><nlm:aff id="aff12">Medical Oncology, Institut Bergonié, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="Gelber, R D" sort="Gelber, R D" uniqKey="Gelber R" first="R. D." last="Gelber">R. D. Gelber</name><affiliation><nlm:aff id="aff2">International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard School of Public Health, Frontier Science and Technology Research Foundation, Boston, USA</nlm:aff></affiliation></author><author><name sortKey="Price, K N" sort="Price, K N" uniqKey="Price K" first="K. N." last="Price">K. N. Price</name><affiliation><nlm:aff id="aff2">International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard School of Public Health, Frontier Science and Technology Research Foundation, Boston, USA</nlm:aff></affiliation></author><author><name sortKey="Goldhirsch, A" sort="Goldhirsch, A" uniqKey="Goldhirsch A" first="A." last="Goldhirsch">A. Goldhirsch</name><affiliation><nlm:aff id="aff8">Department of Medicine, European Institute of Oncology, Milan, Italy</nlm:aff></affiliation><affiliation><nlm:aff id="aff13">Oncology Institute of Southern Switzerland, Bellinzona, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Gusterson, B A" sort="Gusterson, B A" uniqKey="Gusterson B" first="B. A." last="Gusterson">B. A. Gusterson</name><affiliation><nlm:aff id="aff14">International Breast Cancer Study Group Central Pathology Review Office, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK</nlm:aff></affiliation></author><author><name sortKey="Coates, A S" sort="Coates, A S" uniqKey="Coates A" first="A. S." last="Coates">A. S. Coates</name><affiliation><nlm:aff id="aff15">School of Public Health, University of Sydney, Sydney, Australia</nlm:aff></affiliation></author></analytic><series><title level="j">Annals of Oncology</title><idno type="ISSN">0923-7534</idno><idno type="eISSN">1569-8041</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Background:</bold> On average, aromatase inhibitors are better than tamoxifen when used as initial or sequential therapy for postmenopausal women with endocrine-responsive early breast cancer. Because there may be contraindications to their use based on side-effects or cost, we investigated subgroups in which aromatase inhibitors may be more or less important.</p><p><bold>Patients and methods:</bold> Breast International Group 1-98 trial randomized 6182 women among four groups comparing letrozole and tamoxifen with sequences of each agent; 5177 (84%) had centrally confirmed estrogen receptor (ER) positivity. We assessed whether centrally determined ER, progesterone receptor (PgR), human epidermal growth factor receptor 2, and Ki-67 labeling index, alone or in combination with other prognostic features, predicted the magnitude of letrozole effectiveness compared with either sequence or tamoxifen monotherapy.</p><p><bold>Results:</bold> Individually, none of the markers significantly predicted differential treatment effects. Subpopulation treatment effect pattern plot analysis of a composite measure of prognostic risk revealed three patterns. Estimated 5-year disease-free survival for letrozole monotherapy, letrozole→tamoxifen, tamoxifen→letrozole, and tamoxifen monotherapy were 96%, 94%, 93%, and 94%, respectively, for patients at lowest risk; 90%, 91%, 93%, and 86%, respectively, for patients at intermediate risk; and 80%, 76%, 74%, and 69%, respectively, for patients at highest risk.</p><p><bold>Conclusion:</bold> A composite measure of risk informs treatment selection better than individual biomarkers and supports the choice of 5 years of letrozole for patients at highest risk for recurrence.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Oncol</journal-id><journal-id journal-id-type="hwp">annonc</journal-id><journal-id journal-id-type="publisher-id">annonc</journal-id><journal-title-group><journal-title>Annals of Oncology</journal-title></journal-title-group><issn pub-type="ppub">0923-7534</issn><issn pub-type="epub">1569-8041</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21335417</article-id><article-id pub-id-type="pmc">3179413</article-id><article-id pub-id-type="doi">10.1093/annonc/mdq738</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject><subj-group><subject>Breast Cancer</subject></subj-group></subj-group></article-categories><title-group><article-title>Which patients benefit most from adjuvant aromatase inhibitors? Results using a composite measure of prognostic risk in the BIG 1-98 randomized trial</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Viale</surname><given-names>G.</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Regan</surname><given-names>M. M.</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Dell'Orto</surname><given-names>P.</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Mastropasqua</surname><given-names>M. G.</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Maiorano</surname><given-names>E.</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Rasmussen</surname><given-names>B. B.</given-names></name><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>MacGrogan</surname><given-names>G.</given-names></name><xref ref-type="aff" rid="aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Forbes</surname><given-names>J. F.</given-names></name><xref ref-type="aff" rid="aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Paridaens</surname><given-names>R. J.</given-names></name><xref ref-type="aff" rid="aff7">7</xref></contrib><contrib contrib-type="author"><name><surname>Colleoni</surname><given-names>M.</given-names></name><xref ref-type="aff" rid="aff8">8</xref></contrib><contrib contrib-type="author"><name><surname>Láng</surname><given-names>I.</given-names></name><xref ref-type="aff" rid="aff9">9</xref></contrib><contrib contrib-type="author"><name><surname>Thürlimann</surname><given-names>B.</given-names></name><xref ref-type="aff" rid="aff10">10</xref></contrib><contrib contrib-type="author"><name><surname>Mouridsen</surname><given-names>H.</given-names></name><xref ref-type="aff" rid="aff11">11</xref></contrib><contrib contrib-type="author"><name><surname>Mauriac</surname><given-names>L.</given-names></name><xref ref-type="aff" rid="aff12">12</xref></contrib><contrib contrib-type="author"><name><surname>Gelber</surname><given-names>R. D.</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Price</surname><given-names>K. N.</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Goldhirsch</surname><given-names>A.</given-names></name><xref ref-type="aff" rid="aff8">8</xref><xref ref-type="aff" rid="aff13">13</xref></contrib><contrib contrib-type="author"><name><surname>Gusterson</surname><given-names>B. A.</given-names></name><xref ref-type="aff" rid="aff14">14</xref></contrib><contrib contrib-type="author"><name><surname>Coates</surname><given-names>A. S.</given-names></name><xref ref-type="aff" rid="aff15">15</xref></contrib><on-behalf-of>for the BIG 1-98 Collaborative and International Breast Cancer Study Groups</on-behalf-of></contrib-group><aff id="aff1"><label>1</label>International Breast Cancer Study Group Central Pathology Office, Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy</aff><aff id="aff2"><label>2</label>International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard School of Public Health, Frontier Science and Technology Research Foundation, Boston, USA</aff><aff id="aff3"><label>3</label>International Breast Cancer Study Group Central Pathology Office, Department of Pathological Anatomy, University of Bari ‘Aldo Moro’, Bari, Italy</aff><aff id="aff4"><label>4</label>Department of Pathology, Herlev Hospital, Herlev, Denmark</aff><aff id="aff5"><label>5</label>Department of Pathology, Institut Bergonié, Bordeaux, France</aff><aff id="aff6"><label>6</label>Australian New Zealand Breast Cancer Trials Group, University of Newcastle, Calvary Mater Newcastle, Newcastle, Australia</aff><aff id="aff7"><label>7</label>Department of Medical Oncology, University Hospital Gasthuisberg, Catholic University of Leuven, Leuven, Belgium</aff><aff id="aff8"><label>8</label>Department of Medicine, European Institute of Oncology, Milan, Italy</aff><aff id="aff9"><label>9</label>National Institute of Oncology, Budapest, Hungary</aff><aff id="aff10"><label>10</label>Swiss Group for Clinical Cancer Research, Breast Center, Kantonsspital, St Gallen, Switzerland</aff><aff id="aff11"><label>11</label>Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark</aff><aff id="aff12"><label>12</label>Medical Oncology, Institut Bergonié, Bordeaux, France</aff><aff id="aff13"><label>13</label>Oncology Institute of Southern Switzerland, Bellinzona, Switzerland</aff><aff id="aff14"><label>14</label>International Breast Cancer Study Group Central Pathology Review Office, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK</aff><aff id="aff15"><label>15</label>School of Public Health, University of Sydney, Sydney, Australia</aff><author-notes><corresp id="cor1"><label>*</label><italic>Correspondence to:</italic> Prof G. Viale, Division of Pathology and Laboratory Medicine, European Institute of Oncology, Via Ripamonti 435, 20141 Milano, Italy. Tel: +39-(080)-5748-9419; Fax: +39-(080)-5748-9417; E-mail: <email>giuseppe.viale@ieo.it</email></corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2011</year></pub-date><pub-date pub-type="epub"><day>18</day><month>2</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>10</month><year>2012</year></pub-date><pmc-comment> PMC Release delay is 12 months and 0 days and was based on the
<volume>22</volume><issue>10</issue><fpage>2201</fpage><lpage>2207</lpage><history><date date-type="received"><day>15</day><month>11</month><year>2010</year></date><date date-type="accepted"><day>19</day><month>11</month><year>2010</year></date></history><permissions><copyright-statement>© The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com</copyright-statement><copyright-year>2011</copyright-year></permissions><abstract><p><bold>Background:</bold> On average, aromatase inhibitors are better than tamoxifen when used as initial or sequential therapy for postmenopausal women with endocrine-responsive early breast cancer. Because there may be contraindications to their use based on side-effects or cost, we investigated subgroups in which aromatase inhibitors may be more or less important.</p><p><bold>Patients and methods:</bold> Breast International Group 1-98 trial randomized 6182 women among four groups comparing letrozole and tamoxifen with sequences of each agent; 5177 (84%) had centrally confirmed estrogen receptor (ER) positivity. We assessed whether centrally determined ER, progesterone receptor (PgR), human epidermal growth factor receptor 2, and Ki-67 labeling index, alone or in combination with other prognostic features, predicted the magnitude of letrozole effectiveness compared with either sequence or tamoxifen monotherapy.</p><p><bold>Results:</bold> Individually, none of the markers significantly predicted differential treatment effects. Subpopulation treatment effect pattern plot analysis of a composite measure of prognostic risk revealed three patterns. Estimated 5-year disease-free survival for letrozole monotherapy, letrozole→tamoxifen, tamoxifen→letrozole, and tamoxifen monotherapy were 96%, 94%, 93%, and 94%, respectively, for patients at lowest risk; 90%, 91%, 93%, and 86%, respectively, for patients at intermediate risk; and 80%, 76%, 74%, and 69%, respectively, for patients at highest risk.</p><p><bold>Conclusion:</bold> A composite measure of risk informs treatment selection better than individual biomarkers and supports the choice of 5 years of letrozole for patients at highest risk for recurrence.</p></abstract><kwd-group><kwd>aromatase inhibitor</kwd><kwd>breast cancer</kwd><kwd>prognostic factor</kwd><kwd>tamoxifen</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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